On August 24th, Therapro’s Saturday Seminar Series returned from summer hiatus with a timely and very well received presentation from Karen Hefler, OT, OTR, entitled Back to School Bootcamp! Karen is the owner/director of Rehabilitation Therapy Associates LLC, a Massachusetts pediatric occupational therapy private practice that serves schools by providing contract services, assessment services, direct therapy services, and consultation. Additionally, her company provides in-service training for academic staff and parents, program development and program evaluation. Additionally, Karen is the current president of the Massachusetts Association for Occupational Therapy (MAOT).

Karen’s expertise was evident in her practical and comprehensive presentation that covered a myriad of hot topics. The audience, comprised of occupational therapy practitioners, peppered her with questions, comments, and shared ideas and concerns throughout the 2+ hour seminar. She achieved the learning objectives she established for the seminar that included: 1) identifying strategies for setting up classrooms and inclusionary activities; 2) using occupational therapy appropriately with Response to Intervention; and 3) reviewing Common Core Standards and their application to occupational therapy.

Karen offered helpful hints to facilitate a smooth start to the new academic year. She recommended checking IEPs and 504s right off the bat to ensure they’re signed and state the correct service delivery. She also recommended meeting with the team versus meeting with each professional individually to maximize time and coordination of services.

By visiting classrooms at the start of the school year, OTs can check out the classroom environment and design, seating, and tools available to students such as paper, writing implements, scissors, fidgets, etc.

To maintain lines of communication with teachers and parents, Karen offered a number of creative ideas that result in “embedding” the OTs into the school environment. Suggestions included signed and shared consultation sheets, creating an OT web page, newsletter, or blog, and offering an OT “Tip of the week.”

Karen concisely yet thoroughly reviewed RtI (Response to Intervention), also known as multi-tiered systems of support (MTSS). It is an approach to service delivery that encompasses both general and special education that matches the student’s needs. For additional information, Karen referred to AOTA’s 2014 publication, Frequently Asked Questions (FAQ): Response to Intervention for School-Based Occupational Therapists and Occupational Therapy Assistants.

Reminding ourselves of the role of the occupational therapy practitioner in an educational setting is imperative! In summary, “School based occupational therapy services are not about remediation, but are about one’s ability to engage in education.” We truly appreciate the excitement and dialog generated by Karen’s seminar regarding the challenge of being a school-based occupational therapy practitioner!

Here are just a few of the many passionate responses from attendees at Karen’s seminar:

“The current practice information is very helpful. Thank you very much.” – Nancye K., Occupational Therapist

“So knowledgeable, flexible, well spoken and generous with info & resources! Thank you!” – Beth B., Occupational Therapist

“Karen did a wonderful job providing sound information to work “smarter not harder.” This workshop helped me understand my “why” and has brought a sense of clarity going into the school year! Thank you!” – Tara G., Occupational Therapist

“Extremely helpful!” – Elizabeth D., Occupational Therapist

Thank you, Karen!

Filomena Connor, OT, MS, OTR
August 24, 2019

June Smith, OTR/L’s May 4th seminar entitled: Integrated Learning Concepts: Practical Strategies to Promote Reflex Integration with Postural/Ocular-Motor Based Learning clearly demonstrated how integration of primitive reflexes provides a foundation for the development of postural and ocular motor skills that affect learning.

June has broad experience as an occupational therapist and has an insatiable appetite for learning. As evidenced in her presentation, she is able to skillfully apply what she has learned to her practice. Many attendees noted how beautifully June weaves her knowledge and experience into her practice to develop innovative, effective treatment strategies. She is a collaborative therapist who enjoys sharing her passion with others. Currently she is a clinician and mentor at South Shore Therapies, a private sensory integration clinic in Massachusetts. She has developed a Vision Clinic with Developmental Optometrists to promote visual efficiency in those with learning challenges. June has lectured nationally on Brain Gym ® and Integrated Learning concepts.

Four primitive reflexes were discussed in depth today: Moro Reflex, Tonic Labyrinthine Reflex (TLR), Symmetrical Tonic Neck Reflex (STNR), and the Asymmetrical Tonic Neck Reflex (ATNR). June provided general guidelines to determine when a primitive reflex is adaptive and when it is maladaptive. She discussed treatment considerations relevant to each primitive reflex. It was helpful that June had many clinical examples through videos/photos showing how primitive reflexes that are not fully integrated manifest themselves in children and videos/photos of treatment strategies that help integrate the reflexes. Throughout her talk, she drew from her Brain Gym® training, Svetlana Masgutova (Reflex Integration-MNRI), Sheila Frick, and others.

For a child who displays the TLR reflex long after it is typically integrated, June said we may see a host of associated behaviors such as the Moro Reflex where the child is toe walking due to an excessive extensor pattern; saccadic eye movements with reading difficulties; a poor sense of direction, developmental coordination disorder (DCD), Postural Ocular Disorders; hypersensitivity to vestibular activity where the child has motion sickness, dislikes gym class, and/or may have gastrointestinal issues; and has difficulty with extension prone or with neck flexion in supine. In general the child has poor balance of extension and flexion when the reflex is not integrated. Her treatment strategies include “going with the reflex” with fluid movement and gradually adding demands as tolerated, and finally working “against” the reflex. June’s treatment suggestions included activities involving facilitating head movement in all planes, linear vestibular input, using an 18″ Gymnic ball in 90/90 hip and knee flexion, and activation of the vestibular system.

June’s suggestions for therapeutic and reading materials include Rappin’ on the Reflexes: A Practical Guide to Infant Reflexes; See It. Say It. Do It!, whose author is a Developmental Optometrist; Developing Ocular Motor and Visual Perceptual Skills; and Understanding and Managing Vision Deficits: A Guide for Occupational Therapists, 3rd Ed.

June is a vibrant, generous, and gifted speaker whose knowledge and clinical expertise is extensive. She makes the application of what she has learned to the clinical setting seamless. Encouraged by June, attendees eagerly shared treatment strategies from their own clinical experiences. June’s audience was energized by her discussion and walked away with new treatment tools for immediate use!

Comments from attendees were very positive:

“Video and picture examples, interactive, and great descriptions of treatment activities/considerations.” – Kristina C., Occupational Therapist

“Great crash course in identifying and integrating reflexes. It is easily integrated into my own practice. For a complicated topic, very effortlessly presented.” – Hannah D., Occupational Therapist

“As an OT student this seminar was a great learning opportunity.” – Paige H., OTS

“Great introduction to topic – makes me feel like I want more!” – Anonymous, Occupational Therapist

Thank you, June!

Filomena Connor, MS, OTR/L
May 4, 2019

Cleopatra Knight-Wilkins, OTD, MED, OTR/L presented a joyful April Saturday Seminar at Therapro headquarters entitled: Rhythm of the Words: Integrating Multicultural Songs & Games with Occupational Therapy to Promote Literacy. Attendees were up on their feet, moving, clapping and singing for most of the two hour seminar. Dr. Knight-Wilkins led the attendees in activities that engaged their sensory systems. She discussed how the songs and games can be used as part of the therapeutic process as well as how they can be used to target educational goals.

Cleopatra’s rich and extensive experience as an occupational therapist, educator, and performing artist has fueled her passion for integrating musical elements with occupational therapy modalities by using multicultural songs, games, and movement patterns to address the occupation of literacy. Currently, she is in the process of publishing her research-based, multi-media curriculum resource guide entitled Rhythm of the Words: Integrating Multicultural Songs & Games with Occupational Therapy to Improve Literacy. She presented a poster session at the AOTA Annual Conference in New Orleans earlier this month on this topic.

AOTA advocates for the role of occupational therapists in supporting literacy. Research indicates that movement and music improve literacy development. Cleopatra cited a number of interesting studies that demonstrate that isolated handclapping songs result in improved motor and cognitive skills. One particular study that examined training classroom handclapping songs versus participation in music appreciation classes found that training handclapping songs was more efficient in developing literacy skills in 2nd and 3rd grade children than was participation in music appreciation classes.

Attendees formed small and large groups to participate in ‘warm up’ activities, games that involve imitation and chanting, and musical play with graded complexity of movements. Favorites included “Head ‘N Shoulders Baby” played with a partner clapping in various patterns, and “Button You Must Wander,” where a button is passed secretly around a circle while “It” sits in the center of the circle and must guess who has the button. In addition to games and chants, Cleopatra recommended musical CDs such as Make a Sound and Move Around, Simplified Rhythm Stick Activities, and Songames for Sensory Processing. Using Gertie Balls to bounce, catch, and throw to a rhythm, chant, or song can address visual motor, fine motor, and timing skills.

Dr. Knight-Wilkins was an engaging presenter who demonstrated that music, rhythm and movement offer a unique, evidence-based approach to improving language literacy in children of all ages and abilities.

Take a look at some comments from attendees:

“Enjoyed the ‘occupation’ of children reminder! Could implement activities for a whole group and at individual desks.” – Adriana M,, Occupational Therapist

“Something different but very relevant to school-based practice, especially when many schools now have lost funding for music programs.” – Jennifer C., Occupational Therapist

“Cleo was lovely & entertaining. Very knowledgeable. Different perspective on the regular teaching method.” – Anonymous, Occupational Therapist

“Movement to songs was wonderful – I can see how my students would enjoy it. Reminds me that I want to put music/rhythm in my sessions more often.” – Janet L., Occupational Therapist

Thank you, Cleopatra!

Filomena Connor, MS, OTR/L
April 13, 2019