Running head: Co-Teaching Program

Occupational Therapy Co-Teaching Program

Colton Savage
University of Utah College of Health

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Needs Analysis

Introduction
A needs analysis was conducted in Washington County School District (WCSD) to find
an area of need that can be filled through a new program implemented by the Districts
occupational therapy department.
Setting
This needs analysis took place in WCSD. This school district covers the entirety of
Washington County, Utah, including all 8 high schools as well as the middle, intermediate, and
elementary schools that feed into the high schools (Secondary Education Department, 2015).
Washington County is the most Southwestern county in the state of Utah. It is made up of two
different geographic locations: the Colorado Plateau, and the Basin and Range province (Utah
Department of heritage & Arts, 2016). As of 2015 the Countys population was 155,602 (United
States Census Bureau, 2015).
WCSDs mission statement is, Improve Student Achievement (Mission, Vision and
Goals, 2015). Their purpose is to ensure high levels of learning for every student. The SP ED has
a distinct purpose that corresponds to the Countys overall mission statement, which is, ensuring
high levels of learning for every student (Special Education, 2016). The school district does not
have a specified philosophy at this time.
The specific population that WCSDs occupational therapy department works with
consists of an estimated 4,000 students that qualify for an individual education plan (IEP), and
some type of special education services. These students require these services due to some factor
that prevents or decreases the students ability to participate in the classroom including those

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who are suspected of being a student with a disability (Philip Lamoreaux, personal
communication, September-October 2016; Special Education, 2016).
The SP ED provides the needed services that can improve a students ability to participate
in school. Services provided focus on: assessment for eligibility of services, behavior, early
childhood, hearing and vision, motor services which includes physical therapy and occupational
therapy, speech language pathology, technology support, and transition. They are beginning to
assist with sensory services using occupational therapy as well (Philip Lamoreaux, personal
communication, September-October 2016). The staff for the SP ED includes: administration,
cone site (all schools that feed into a specific highschool) coordinators, technology specialists,
and supporting services (occupational therapists, physical therapists, speech language
pathologists, and psychologists) (Special Education, 2016).
Special education funding in WCSD relies mostly on Medicaid. Medicaid is provided
when a student is found to need an IEP and special or supporting services through
evaluation/assessment.
Services provided in the SP ED within recent history consisted of the supporting services
pulling the students out of the classroom to work on their needs. The therapists would evaluate
each child for service needs, participate in the IEP, and after that, rarely see the student
personally. The students were seen by paraeducators who had only some training in therapy, but
were instructed to implement the therapists intervention plans. The therapist would rarely have
the opportunity, due to limited resources, to see the student between IEP evaluations.
Administration Data Collection
Semiformal interviews were performed with administration staff. They were all
structured the same. A specific set of questions was used for all administration interviews (see

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Appendix A for interview format). The list of questions was taken into each interview, but were
added upon, or altered, when needed.
Strengths. There was a lot to be said by the administration staff about the occupational
therapy department in the interviews. Hollee Cullen is the countys special education coordinator,
who covers all of the compliance for special education. She had 10 years of educational
experience in WCSD as a mild/moderate teacher before becoming a coordinator. She described
her past experience in the district with occupational therapy as minimal. In relation to sensory
needs, in the past it was considered a no-no, and she stated that they were told, do not say the
word sensory (Cullen, H., September 15, 2016). The impression that I received is that sensory
wasnt understood and wasnt felt as an integral part of the student. They were focused on
behavioral causes instead. Now with the new direction of the current OT staff she stated, I see it
now becoming more of a sensory/behavioral componentits more of a bigger picture of how we
can modify what [theyre] doing and change behaviorally and sensory (Cullen, H., September
15, 2016).
As the new therapy team has taken over, another area of strength that was found is the
education they have begun to give to the teachers about what occupational therapy is, as well as
the things that can be done in their classrooms to promote a students skills. Michelle North, the
principal for Bloomington Hills Elementary appreciated the training that was given to her
teachers. She invited the OT who was over her school to come in for workshops to show some
of the things that [her] teachers could build into a center that they would be able to use [with the]
whole class, [things] that they could practice (North, M., September 14, 2016). It was also
mentionioned by Hollee Cullen that she too liked the training aspect where the therapist started

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going in and training schools. She stated that, [its] been very well received and very helpful
(Cullen, H., September 15, 2016).
Areas for growth. Lee Ann Parkinson is a cone site coordinator over Dixie High. This
means that she is a coordinator over all the elementary, intermediate, and middle schools that
feed into Dixie High School. She is also a coordinator over all the alternative locations such as
Post High and the Alternative High. When asked about areas for growth that she could see she
stated, Id just like to see more services and more training [for] school teams (Parkinson, L. A.,
September 19, 2016).
One area that needs assistance in WCSD is their early intervention through the
preschools. Lisa Creager is the Site Lead Teacher at Riverside Preschool. Her job is to teach the
classroom educators. She is the equivalent of a principal in the preschool. During the interview
there was a discussion on the need for the therapist in the classroom. She appreciates the help
that the paraeducators provide in implementing the programs, but she feels that if the therapists
are truly going to help the students, they need to spend more time in the classroom. She stated
that, creating an opportunity for [the therapists] to be here a little bit more is a great direction to
go in (Creager, L., October 2, 2016).
Client Data Collection
The clients in this instance are severe special needs children who would not be able to
answer the questions for themselves about occupational therapy and needed services. Instead
their caregivers, in the form of severe classroom teachers, paraeducators, and motor aids, were
interviewed. Data collection for client interview was performed through two formats. The first
was of a special education severe classroom teacher at Sunrise Ridge Intermediate School. He
was interviewed using the same set of questions as the administration staff (see Appendix A).

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The rest of the information was gathered using informal interviewing of paraeducators in the
classroom as well as motor aides through conversations. Recently, within the last year, the
therapy department has been educating paraeducators as motor aids with a greater knowledge of
anatomy and other subjects in order to increase their ability to assist in therapy. They are now
educating the special education teachers on what each therapy is and how it can benefit the
children. Their ultimate goal is to become a fully collaborative program. This program proposal
is meant to assist with that goal (Philip Lamoreaux, personal communication, September-October
2016).
Strengths. The strengths for the services currently provided to the client were found
through conversations with the paraeducators. They discussed the importance of the training that
they were receiving to help the children. Specifically, the motor aides were appreciative of the
anatomy and motor training they received because they felt they were better able to assist the
children now. They now knew how to implement the therapists intervention plans better, and
actually see improvement in the children. (Marcie, personal communication, September-October
2016). All interviewed also felt an appreciation for the innovation that was taking place in the
School District.
Areas for growth. James Brey is a teacher of children with significant and cognitive
disabilities. He oversees the alternative assessments, meaning that he trains teachers and is in
charge of making sure the assessments are submitted to the state. He also has his own caseload of
10 severe students in a classroom. Mr. Brey stated that teachers and related servicesneed to
work collaboratively together so that its just not two times a weekbut an OT can come into my
classroom at any time (Brey, J., September 14, 2016). When the therapist can come into the
classroom at any time he will be able to come to the occupational therapist to say Ive come to a

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brick wall on this one, could you help me to the next visual perceptual part (Brey, J., September
14, 2016).
The paraeducators also had something to say about areas of growth for the OT
department in the district. They felt that more direct interaction of the therapist in the classroom
working with the children, as well as more training from the therapists in the classroom, would
benefit the children. (Classroom Paraeducators, personal communication, September-October
2016)
Observation
The final mode of data gathering used for the project was observations, which were
performed throughout the two weeks of fieldwork through meetings, participation in lessons, and
participation in direct therapy with students.
Strengths. There were many strengths of this site observed by this student during his
fieldwork experience. The therapy team had a great desire to provide more assistance in the
childs classroom to truly ascertain the needs for participation in their education and what
assistance could be provided. They also want a greater opportunity to educate and answer
questions from the severe teachers in the classroom.
The lessons that are being created for the occupational therapy department focus more on
trying to educate the children in the classroom instead of pulling them out in a separate room as
well as leaving something for the teacher to implement daily throughout the week, that supports
the services given by the therapist, before the therapist can visit again. They have also created a
documentation system that allows for the teachers to keep track of the minutes that are being
done throughout the week.

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Personally, I had the opportunity to work one-on-one with a student educating them on
forming the letter a through a letter story, which is one of the new lessons being used in the
classroom. The child, who previously had difficulty producing the letter on request, was able to
do so with the specific training through this story. This need for a new method was obtained
through the extra time the therapist was able to spend in that classroom.
Areas for growth. A meeting took place between the supervising therapist for fieldwork
in the school district and the special education administrator over preschools. The meetings
purpose was to discuss questions about documentation on motor minutes that had arisen, but
during the meeting the administrator mentioned that there needed to be more daily practice in the
classrooms for severe students. For severe students, the current curriculum of pulling the
students out of the classroom every couple of weeks wasnt enough for retention. They needed
more daily practice. It was also observed that they need education on what to practice for greater
improvement.
Through my entire two weeks of observation, one distinct theme stood out to me. For the
children in the severe classroom to learn and retain the lessons that were being taught to them in
the classroom, OT-directed practice needs to occur on a daily basis. Along with this, there needs
to be more time with the therapist in the classroom educating the teacher and paraeducators on
how to perform this daily practice. There also needs to be more direct OT services with the
children. For this to occur, a change in mode of delivery needs to fully take place. There needs to
be a change to a collaborative co-teaching model to redistribute the therapists available time and
efforts toward more direct services.

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Literature Review

Introduction
Within the public school system occupational therapy services are considered related
services in which the therapist provides the needed supports to allow children to obtain their
educational goals. These services are provided through two different models including:
consultative services in the classroom and direct services. In the past direct services were done
through a pull-out method where the students were taken out of the classroom and services were
provided, as well as consultative services with the classroom teachers as well as the assistances
in the classroom (Case-Smith, & Cable, 1996). The proposed co-teaching/collaborative system
proposed for the current program development still allows for these two types of services, though
they may be provided differently than in most school systems.
Through observation of Washington County School District (WCSD), as well as
interviews and hands on experience, it has been found that more direct services need to be
provided by occupational therapists (OT) to the students with severe involvement. These services
will be provided using the two models of service, direct and consultative services, through a coteaching model. Cook and Friend (1995) define co-teaching as two or more professionals
sharing their responsibilities for a diverse group of students in one classroom (pp. 1). For this
program the professionals are teachers, paraeducators, and therapists. The purpose of this
literature review is to discuss how collaborative practices, through a co-teaching model, can
improve the success of students with severe disabilities in the classroom as well as the benefits of
increased daily practice for students.

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Benefits Of Collaborative Practice

Interprofessional collaboration (IC) is an important aspect in both clinical and school
based occupational therapy practice. Green and Johnson (2015) discussed the importance of IC.
IC takes place when two or more professions come together to work toward a common goal. This
can be used to solve problems and issues. The article states that, the benefits of collaboration
allow participants to achieve together more than they can individually, serve larger groups of
people, and grow on individual and organization levels (Green & Johnson, 2015, pp. 1). Not
only is it important, but also it is required.
Orentlicher, Handley-More, Ehrenberg, Frankel, and Markowitz (2014) discuss the
importance of interprofessional collaboration. First, it is mandated by the Individuals with
Disabilities Education Improvement Act, and second, collaboration is a team process where the
OTs, other related service providers, educators, student, and family members work together to
help improve the students school performance.
When teamwork isnt present children may not receive all the help that they may need. In
Case-Smith, (1997) she discussed the importance of teamwork between teachers and the
therapist. When a situation comes up that the educator doesnt understand or agree with the
therapist, then the therapist is placed in a situation where they dont know what to do.
Collaboration, on the other hand, can lead to outcomes that include an increase in support and
opportunity for children, an improvement in skills related to communication and understanding
cultures, as well as placing students in the least restrictive environment. (Orentlicher, et al.
2014). Through a collaborative model where all involved in the student work together, the
student can flourish and perform at their best.

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Successful Co-Teaching Programs

Traditionally school-based occupational therapy services consisted of direct services,
which used a pull-out method, and consultative services. Jane Case-Smith and Judy Cable (1996)
compared how much of each type of services was used by 321 school-based occupational
therapists as well as the therapists attitudes towards the services. It was found that the services
were used quite evenly, 47% pull-out services and 53% consultation. What was important to this
program proposal though are the attitudes towards these services. In general the therapists had
positive attitudes toward consultative services. They enjoyed being able to discuss their
knowledge with the teachers, and they felt that therapy should be integrated throughout the
school day (Case-Smith, & Cable, 1996, pp. 1). On the other hand they did not feel that the
children were best served when the pull-out method was used. In the end they stated that, they
identified advantages to the use of both models and seem to believe that children are best served
when direct services are combined with those that integrate therapy into the classroom and
involve consultation with the teachers (Case-Smith, & Cable, 1996, pp. 1). This is the basic
premise for this program proposal, and the idea on which this programs co-teaching method is
based.
Co-teaching has been shown to be successful while used in the general classroom. It is
increasingly being used in schools to provide services to students with disabilities. Research has
shown that co-teaching shows positive effects on student achievement (Walsh, 2012). Most of
the studies on co-teaching involving OTs consists of the OT in the general classroom providing
handwriting services to the student (Case-Smith, Holland, Lane, & White, 2012; Case-Smith,
Weaver, & Holland, 2014). The benefits of these programs are expected to continue when the OT
provides co-teaching services to students in severe special education classrooms.

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The design for this co-teaching program can be found in a couple of different sources. In
one study Case-Smith, Holland, Lane, and White (2012) discussed that co-teaching, consists of
a general educator paired with a special education teacher or related services profession
providing instruction in a class (pp. 397). It goes on to discuss that the therapists and teacher
should collaboratively plan, coordinate, implement, and evaluate the classroom instruction (pp.
397). They work together manage the classroom, plan interventions and classroom instruction,
and evaluate the students performance. Factors that need to be present for teachers to be more
successful with these students include education on modification techniques, learning styles,
increasing comfort levels of teachers with disabilities, and providing training to teachers, parents
and administration (Garza, E. R. 1998).
The main goal of this program is to increase OT services to classrooms for students with
severe disabilities by spending more time in the classroom educating the teacher on the students
disabilities and how to provide the needed services to the students. The OT will provide direct
services in the classroom, and between OT direct service visits and teacher education the severe
classroom, the teacher will be expected to implement the techniques taught by the therapist. This
fulfills both models of service, direct OT as well as consultative, and allows for more daily
practice, which will bring about greater improvement.
Relevant Evidence
The main relevant evidence to promote this program is the importance of repetitive
practice. The need that was found in the severe classrooms in WCSD is that the students need
and increased amount of practice in their treatment because the current level of practice isnt
developing the amount of skill acquisition desired by the therapists. Through an increased
amount of time for direct services of the OT in the classroom as well as education for activities

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that can be done by the teacher, the student can have an increased amount of practice and in turn
a greater level of skill acquisition.
Repetitive practice. Repetitive practice has been found to improve motor skill
acquisition in multiple areas of study. There are examples in every day situations where
repetitive practice increases the acquisition of a desired skill. In a study performed on expert
pianists it was determined that practice quantity showed improvement on the selected motor skill
that was being studied (Jabusch, Alpers, Kopiez, Vauth, & Altenmuller, 2009). Rivard, J. D. et al.
(2015) showed that two types of repetitive training, block or random training schedules,
improved skill acquisition for the surgeons who were novices in the specific type of surgery.
More importantly, repetitive practice has also been shown to benefit skill acquisition
when working with children who have severe disabilities. Fiss, Effgan, Paage, and Shasby
(2009) demonstrated that an increase in practice correlated to an increase in motor acquisition for
children with Down Syndrome. There were two groups in the study. In both groups children
received individual intervention, but in the experimental group the children also received
intervention through a sensorimotor group. This article suggests not only the important of an
increased level of practice in promoting skill acquisition, but it also promotes the importance of
group intervention in practice. Not only are the children receiving more services, but it is in a
group which can be time saving for the therapists who have very large caseloads. The researchers
concluded that participation in [the] sensorimotor groups and individual intervention resulted in
greater improvement and motor skill acquisition than solely individual intervention (Fiss,
Effgen, Paage, & Shasby, 2009, pp. 158).
As has been shown, increase in practice is very importing for skill acquisition in many
different areas. Most importantly it was shown to improve skill acquisition in children with

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severe disabilities. The end goal of this program proposal is to increase services provided to the
students in the severe classroom. This goal is based on the premise that increase practice in a
skill will increase acquisition of that skill.
Summary of Literature Review
Through the use of interviews, observations, and participation in therapy a need was
found for more daily interventions, education for the teachers and paraeducators, and an increase
of time for direct therapy from the OT in WCSD. The administration would like to see more
services and training for school teams as well as an opportunity for the therapists to be in the
classrooms more. The caregivers of the students interviewed were the teachers and motor aids.
One specific teacher discussed his opinion that teachers and related-services needed to work
together collaboratively. The aids felt that more direct interaction of the therapist in the
classroom as well as more training from the therapists in the classroom would benefit the
children. Finally, according to my observation in meetings as well as the classroom I discovered
that there needed to be more daily practice for the students.
The research found supports addressing these needs. Collaboration between everyone on
the team provides an environment for greater improvement of the childrens skills. Co-teaching
has proven to be successful in general education classrooms, and I feel that this success is
transferable into the severe special education classroom. Last, research was found to support the
idea that an increase in opportunities to learn skills increases the retention of that skill. This was
found in many areas including for children with a severe diagnosis. This research supports the
focus of providing a co-teaching program based on collaboration and increasing services for the
severe classrooms.

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Program Proposal: Washington County School District

Occupational Therapy Co-Teaching Program
Program Overview
As has been shown in the needs analysis and evidence-based practice sections of this
proposal, a co-teaching program based on an interprofessional collaborative model would be
very beneficial to support the need for more occupational therapy (OT) services in Washington
County School District (WCSD). OT services are not new to WCSD, but are an integral part of
the required services for students in Utah; because of this the name for this new program will
simply be the Occupational Therapy Co-Teaching Program.
As this is a program based on a required service at the site, most of the services provided
will fulfill these requirements. All students in the state of Utah who qualify for special education
services through either an Individualized Education Program (IEP), or a Section 504 qualify for
evaluation and treatment from supporting services which include: OT, Physical Therapy, Speech
Therapy, and Counseling. These are the eligibility requirements for this program as well. With
this in mind the major services that I will describe in this program overview are those that may
be different then the traditional services in a school district. These major services that will be
provided by this new program include weekly-biweekly direct OT services through one-on-one
work with the severe students in their classroom as well as collaboration with the teacher in the
form of education and training. This program will take place Monday-Friday during regular
school hours.
The mission for WCSD is to Improve Student Achievement (Mission, Vision and
Goals, 2015), and the special education department focuses on Ensuring high levels of learning
for every student (Special Education, 2016). This program will fulfill both of these missions

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through the focus on increasing the ability for the therapists to provide direct services more often
to the severe students. It also focuses on educating the teachers in these severe classrooms
through education on the students disabilities and treatments that the teachers and paraeducators
can provide in the classroom.
Professional Support
An occupational therapist will be crucial for implementation of this program. According
to the American Occupational Therapy Association (AOTA), occupational therapy is the only
health profession that focuses their therapeutic practice on helping people in their daily activities
across the entire lifespan. Occupational therapists help people live their life to the fullest through
therapeutic treatment focused on preventing injury, promoting health, and helping individuals
live successfully with their disability (What is Occupational Therapy, 2016).
This program will focus on occupational therapy in schools specifically, the AOTA states:
School-based occupational therapy is designed to enhance the student's ability to fully
access and be successful in the learning environment. This might include working on
handwriting or fine motor skills so the child can complete written assignments, helping
the child organize himself or herself in the environment (including work space in and
around the desk), working with the teacher to modify the classroom and/or adapt learning
materials to facilitate successful participation. (OT in Schools, 2016)
This knowledge that occupational therapists have in relation to therapeutic practice for children
comes from graduate level education that focuses on client factors (mental functions, sensory
functions etc.) and performance skills (motor skills, processing skills, social skills, etc.) that
through disability or illness can become affected and make school participation difficult.
Occupational therapists also receive education on anatomy of the human body, disabilities and

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illnesses, how the environment can be changed to improve participation, and how the specific
tasks (occupations) can be changed to allow for participation. These specific skills are what make
occupational therapists the professionals best fit to implement this program.
For this program the occupational therapist will provide education for the teachers and
paraprofessionals on the disabilities/illness that the students are dealing with as well as
therapeutic interventions that they can implement in the classroom. They will also be educated
on environmental adaptations that they can make to their classroom that can facilitate learning
and prevent distraction. The occupational therapists will also provide direct services to the severe
students on at least a bi-weekly basis.
The assessments that will be used for this program include the Developmental Test of
Visual Perception-3 (DTVP-3), the Bruininks-Oseretsky Test of Motor Proficiency (BOT-2), and
the Sensory Processing Measure (SPM) as these are the assessments already used within the
current program, and they still fulfill the needs for this new co-teaching focus.
Theoretical Foundation
Occupational therapy is a science with multiple theories and models directing the focus
of services provided. The models are placed into two categories: occupation based practice
models and supporting models. The idea of occupational justice will also be also discussed.
Occupation based practice model.
Person-Environment-Occupation model. The occupation based practice model that will
direct this program is the Person-Environment-Occupation (PEO) model. The PEO model
focuses on the transaction between the client, his or her occupations (their daily activities), and
the environment that these occupations take place in. This transaction is described as the
dynamic relationship of each factor, how they affect each other. The occupations for the severe

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students in WCSD incorporate any tasks required to participate in education. This can include
writing, listening, socializing, etc. If there is a factor of the occupations that they cant do,
something that is in the environment that is preventing participation, or an aspect of the
individual that is causing difficulty (inability to attend, or problems with motor control for
example) this transaction is disturbed. Only through intervention can this transaction be brought
back into balance. Whatever the factors that are affecting the students ability to participate in the
school, whether it be from the environment, their occupations, or their own abilities, this model
will direct therapeutic focus on correcting the factors and bringing their transaction back into
balance. (Law et al., 1996).
The PEO model allows for all of the assessments that are planned to be used within this
program. It supports changes in the person (DTVP-3, and BOT-2), as well as environmental
changes (SPM). More detail of these assessments will be discussed in the supporting models.
Supporting models. Three supporting models have been chosen to direct this program.
These include: the Motor Learning, Sensory Processing, and Cognitive Orientation to
Occupational Performance models.
Motor Learning model. The first supporting model chosen for this program is the Motor
Learning model. Motor Learning is described as, the acquisition and modification of learned
movement patterns over time. Motor learning requires practice and experience which leads to
permanent changes in the persons ability to produce movement sufficient to meet the demands
of occupational performance (Pendleton & Schultz-Krohn, 2013, pp. 831). The purpose of the
Motor Learning model in this program is the models focus of practice leading to change in an
individuals ability to produce movement that allows for occupational performance. Through an
increase in daily practice in the classroom via direct OT services, as well as education of daily

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practice for teachers and paraeducators to implement, the children with severe disabilities will be
able to increase their motor control for tasks such as handwriting.
The Motor Learning model supports the use of the BOT-2 assessment. The BOT-2
assessment has 8 subtests focusing on: fine motor precision, fine motor integration, bilateral
coordination, balance, running speed and agility, upper-limb coordination, and strength (Pearson
Education, 2016). As previously discussed the Motor Learning model focuses on repetition and
practice to increase motor control for tasks. To increase the capability for a child with a disability
to perform these 8 skills as described in the BOT-2, a Motor Learning focus will be used.
Sensory Processing model. The Sensory Processing model focuses specifically on the
Sensory Processing Disorder (SPD). Individuals with SPD have difficulty organizing and
assimilating information from their sensory systems. Because of this they experience difficulty
with responding to sensory information in their environment. This in turn can make it
challenging to participate in occupations, or in the case of WCSD, participation in school. There
are multiple sensory systems that can be affected and this affect can involve multiple systems at
once. The systems that can be involved include: Vision, hearing, taste, touch, proprioception
(relation of body in space), vestibular (balance), and smell. The problems that arise from these
difficulties can range from movement disorders, discrimination of sensation, and differing
responses to sensory stimulation. The goal is to determine which sensory systems are being
affected and provide treatment, usually in the form environmental or occupational modifications,
that allow for participation. One of the reasons that this model and disorder are important to
include in this program are the comorbidities with SPD. These include: attention deficit disorder,
autism spectrum disorders, and learning disorders. All of these are common diagnoses seen in

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school systems, and many of those students have sensory issues (Schell, Gillen, & Scaffa, 2014,
pp. 1176).
To determine what sensory systems are being affected the Sensory Processing Measure
(SPM) will be used. The SPM is an assessment used for school children ages 5-12 and provides
scores for the childs praxis (movement), social participation, visual, auditory, tactile,
proprioceptive, and vestibular functioning. These scores are comparable to average same age
peers. This assessment offers descriptive clinical information on processing vulnerabilities,
including under- and overresponsiveness, sensory-seeking behavior, and perceptual problems
(Pearson Education Limited, 2016). The therapist can then take this information and implement
into treatment. An important, and new, aspect of the SPM is that it now consists of three forms: a
home form, classroom form, and school environment form. Now the childs environments can be
compared for these sensory and movement factors (Pearson Education Limited, 2016).
CO-OP model. The CO-OP model is a problem-solving approach to improving
occupational performance through cognitive methodologies. The improvement involves a
stepwise process of first, the therapists using verbal direction, second, the individual using
internal dialogue learned from the therapists examples, and last, the individual problem solves
on their own. The three main objectives addressed by CO-OP are skill acquisition in childchosen tasks, development of cognitive strategies, and the generalisation and transfer of learned
skills and strategies (Missiuna et al.) (Rodger & Brandenburg, 2009).
Depending on the childs areas of improvement, such as handwriting or social skills, the
therapist will first use verbal direction to correct any slip. Over time the child will be encouraged
to use internal dialogue that was taught by the therapist which can come in the form of imagery,
verbal mneumonics, verbal rote script, etc. (McNulty, 2015).

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The CO-OP model supports the use of the DTVP-3. The DTVP-3 assessment has five
subtests focusing on: eye-hand coordination, copying, figure-ground, visual closure, and form
constancy (PRO-ED, Inc. 2012). The way that this assessment relates to the CO-OP model is
through the method of intervention used to improve these five focuses. As described above, in
the CO-OP model, the therapist will use verbal direction to improve upon the childs abilities in
the areas tested through DTVP-3 as well as all other skills the child is working on.
Occupational justice. Occupational justice is the right of everyone to engage in
occupations that are meaningful to them. There are many times where disparities lie in an
individuals ability to participate in their desired occupations. A large portion of these disparities
lie in the individuals abilities, but many of them do not. When the disparity lies in policies, laws,
and or social beliefs, it is the responsibility of the professional to fight for their clients right to
participate (Foti, & Koketsu, 2013, pp. 162).
This program addresses occupational justice in the way that it increases the education for
the severe students and promotes their ability to perform current as well as future occupations. I
think that the closest type of occupational justice this program relates to is occupational
marginalization. Occupational marginalization is described as operating invisibly.with
recognition that humans, individually and as a population, need to exert every day choices as
[they] participate in occupations. Moreover, [they] need a wide range of occupations (Townsend
& Wilcock, 2004). In the school district the severe students have not received the needed amount
of intervention to cause the change they require for participation. This narrows their choices they
have to participation in the classroom. Through the therapists, working more often with the
severe students, as well as giving education and collaboration with the professionals in the
students lives, the students will have a greater choice in interventions that can be more client

Co-Teaching Program

22

centered, research based, and theory driven than they previously have been. They will also have
a greater likelihood of success.
Goals and Objectives
Goal 1: Ensuring high levels of learning for every student through an increase in direct
services provided in the severe special education classrooms.
Objective 1a: The OTR will be completing evaluations on a monthly basis for all
students who qualify for services by May 2017.
Objective 1b: By the end of each school year at least 75% of all severe special
education students will demonstrate an increase in retention of learned skills.
Goal 2: Bringing about an environment that increases success for each student through
environmental adaptation, teacher and paraprofessional education, and research based
practice in the classroom with the implementation of a co-teaching model.
Objective 2a: The OTR will provide education for the teacher and
paraprofessionals on, at least, a bi-weekly basis by May 2017.
Objective 2b: The OTR will create an environment that promotes success for
each student within the severe classrooms by May 2017.
Program Description

Participation
Staff Involvement
Role of Occupational Therapist
Community Resources? May not be doing this one
Space and Time Requirements

Co-Teaching Program

23

Budget
Remember to mention appendix B in this section for referral to a more detailed account of the
budget.
Expected Outcomes

References
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from http://www.aota.org/conference-events/otmonth/what-is-ot.aspx
Brey, J. (September 14, 2016). Interview by C. C. Savage [Audio clip]. Retrievable by emailing
[email protected]
Case-Smith, J. (1997). Variables related to successful school-based practice. Occupational
Therapy Journal of Research. 17(2), 133-153.

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24

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%3d%3d#AN=508575441&db=eft
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Adaptation of Regular Educators In Inclusive Classrooms (Unpublished doctoral
dissertation). Graduate School of the Texas Womans University, Denton, Texas.
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and clinical practice: Working together for a better future. The Journal of Chiropractic
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practice on the development of motor skills in pianists: A longitudinal study in a selected
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Orentlicher, M. L., Handley-More, D., Ehrenberg, R., Frankel, M., and Markowitz, L. (2014).
Interprofessional collaboration in schools: A review of current evidence. Special Interest
Section Quarterly: Early Intervention & School, 21(2). Retrieved from:
http://www.aota.org/Publications-News/SISQuarterly.aspx
Parkinson, L. A. (September 19, 2016). Interview by C. C. Savage [Audio clip]. Retrievable by
emailing [email protected]
Pearson Education. (2016). Bruininks-Oseretsky Test of Motor Proficiency, Second Edition
(BOT-2). Retrieved from
http://www.pearsonclinical.com/therapy/products/100000648/bruininks-oseretsky-test-ofmotor-proficiency-second-edition-bot-2.html#tab-details
Pearson Education Limited. (2016). Sensory Processing Measure (SPM). Retrieved from
http://www.pearsonclinical.co.uk/AlliedHealth/PaediatricAssessments/Sensory/SPM/sens
ory-processing-measure.aspx
Phipps, S. C., & Roberts, P. (2013). Motor Learning. In H. M. Pendelton & W. Schultz-Krohn
(Eds.), Pedrettis occupational therapy: Practice skills for physical dysfunction (pp. 831843). St. Louis, Mo: Elsevier Inc.
PRO-ED, Inc. (2012). DTVP-3: Developmental Test of Visual Percetion Third Edition.
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Rivard,J.D.,Vergis,A.S.,Unger,B.J.,Gillman,L.M.,Hardy,K.M.,andPark.J.(2015).The
Effectofblockedversusrandomtaskpracticeschedulesontheacquisitionandretention
ofsurgicalskills.TheAmericanJournalofSurgery,209(1),93100.
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Rodger, S., & Brandenburg J. (2009). Cognitive Orientation to (daily) Occupational Performance
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performance goals. Australian Occupational Therapy Journal. 56, 41-50. DOI:
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Schell, B. A. B., Gillen, G., & Scaffa, M E. (2014). Appendix I: Common conditions, resources,
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10.1177/000841740407100203
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http://www.census.gov/quickfacts/table/PST045215/49053
Utah Department of heritage & Arts. (2016). Washington County. Retrieved from
http://ilovehistory.utah.gov/place/counties/washington.html
Walsh, J. M. (2012). Co-Teaching as a school system strategy for continuous improvement.
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Washington County School District. (2015). Mission, Vision and Goals. Retrieved from
http://washk12.org/district-info/mission-vision-and-goals
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Washington County School District. (2016). Special Education. Retrieved from
http://specialed.washk12.org/

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Appendix A
Basic Interview Format
1.
2.
3.
4.
5.
6.

What is your name?

What is your title?
How does your work benefit the children in this district?
What is your understanding of occupational therapy?
What benefits have you seen in the district from occupational therapy?
How do you currently see occupational therapy being implemented?
a. In classroom vs. out of classroom?
7. What do you find that is missing in the classroom related to occupational therapy & and
other related services.
a. Do you feel supported in this need currently?

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Appendix B
Source of Specific costs or sources of
income
Start-up Costs
In Kind

Direct Costs
In Kind

In Kind

Cost

Training
Assuming 10% of total salary, minimal
training required.
Chairs
6 (1 for each therapist/aid) x $30.00
Tables
3 (1 for each pair of therapist/aid) x $100
Total=

$11,016.00

Part-Time OTR Salary for 3 OTs

($34.00 x 30/hours per week x 36 weeks) x
3 occupational therapists
The county therapists are full time, but some
time is spent in meetings/trainings/etc.
($13.50 x 29.5/hours per week x 36 weeks)

$110,160.00

$180
$300
$11,016.00

$43,011.00

Co-Teaching Program

In Kind
In Kind
In Kind

Indirect Costs
In Kind
In Kind

30

x 3 paraeducator. Each OTR has a full time

paraeducator for 29.5 hours a week
Fringe Benefits 15% of salary (for OTs,
assistants arent benifited)
$110,160 x .15
Travel Expenses (gas for driving)
($.54/mile x 20 miles/day x 180 days) * 6
employees (36 week year =180 days)
Supplies:
Sensory Processing Measure
Developmental Test of Visual Processing
Third Edition (DTVP-3)
Bruininks-Oseretsky Test of Motor
Proficiency, Second Edition (BOT-2)
Paper and Writing Tools (~$15/week)
Miscellaneous supplies such as items for
activities ($25/week)
Total=
Maintenance
Utilities

$16,524.00
$11,664.00

$322.50
$257.00
$879.40
$540.00
$900.00
$184,257.90

TBD
TBD
Total= TBD

Income

Total costs
In Kind
Contributions
Total net cost

Total=
Budget Summary
$195,273.9
$195,273.9
0