Assistive Technology in Schools was presented by Kristi Voelkerding, BS, COTA/L, ATP, ROH on a brisk February morning at Therapro headquarters with 45 attentive, engaged, interactive, vocal attendees.

Kristi has forged a distinguished career path as an AT specialist who is in demand as a speaker. She has worked for Easter Seals primarily as a consultant mainly in school-based settings since 2000. Her breath of knowledge regarding assistive technology is extensive and current. In a field where technology changes constantly, she is a wonderful resource for therapists, teachers, and families. AOTA conferred upon Kristi a Roster of Honor award in 2007 to recognize her leadership in AOTA and her innovative practices in assistive technology.

Kristi’s seminar spurred audience interaction regarding apps recommended and apps used successfully with various age groups. She discussed using technology as a “bridge” that should be introduced early in school so that students can access learning in ways that are unique to them and their needs. She initiated her talk with discussion about the broad variety of keyboards available that can match a student’s needs. She advocated that the student must find what method of keyboarding is fastest for him/her, be it one finger, one hand, two hands, or even the nose or foot. She suggested creating word lists on the computer to practice learning the geographical area on the keyboard. Kristi cautioned that layering copying (motor task) with thinking about the content of the task (cognitive task) is difficult. She recommended that a speech recognition program be used if the student has difficulty holding the thought while trying to type it. Creating a first draft on the keyboard was recommended rather than writing, and then copying it onto the computer.

Kristi noted that more schools are moving toward using the chromebook because it is more cost effective than an iPad, especially if it’s damaged and needs to be replaced. In addition, work on the chromebook is not lost if the device is damaged. A negative of using the chromebook is that a user cannot be “locked in” to a particular site. User needs must be considered when deciding which device would be best.

Apps are available for all age groups. iTrace is an iPad app for teaching handwriting, spelling, and letter identification. It may be a great place to start with a preschool student. Kristi advocated for using a stylus vs. using a finger for handwriting work, and in this app the student uses a stylus. For students who are moving from high school to college, there is “transition technology” available that promotes the shift from using adult support to depending on technology instead. For older students, she discussed using the Livescribe, a smart pen that facilitates note taking by recording everything you hear, write, and draw. The smartpen records audio and links it to what the student writes. Another note taking app for use with an iPad is Nebo MyScript, which lets you write, draw, quickly edit and structure notes, and convert them into digital text, using a stylus.

Kristi provided a number of resources for PCWindows Programs, Chromebooks/Chrome apps/add-ons/extensions, and Websites/Web-based apps. The resources have grown exponentially in the past few years and continue to swell. We are grateful to Kristi for sharing her expertise and experience navigating this area of practice.

Take a look at some attendees’ positive responses to Kristi’s seminar:

“Kristi was informative & knowledgeable regarding the materials presented. Lots of material I can use on Monday at school.” – Alyson P., Occupational Therapist

“Very informative and interactive. Well presented.” – Jillian N., Occupational Therapist

“Lots of useful info.” – Marisol P., Teacher/Parent

“Very knowledgeable speaker. Very receptive to gearing her talk to audience needs. Lots of info presented.” – Anonymous, Occupational Therapist

“Learned abut some new, exciting, & cutting edge technology.” – Sharon T., Occupational Therapist

Thank you, Kristi!

Filomena Connor, MS, OTR/L
February 23, 2018

The 2019 Therapro Saturday Seminar Series was launched by school-based physical therapists, Dr. Jennifer Colebourn, MSPT, DPT and Dr. Julie Goff, MSPT, DPT with their presentation: The Role of Motor Interventions in Autism Spectrum Disorder.

Jenn and Julie met at Northeastern University where they were pursuing their doctoral degrees. Jenn’s research focuses on motor interventions for Autism Spectrum Disorders. Her most recent work has been published in the journal, Pediatric Physical Therapy: A. Colebourn, Jennifer & C. Golub-Victor, Ann & Paez, Arsenio. (2017). Developing Overhand Throwing Skills For a Child With Autism: A Collaborative Interdisciplinary Approach In School-Based Therapy. Pediatric Physical Therapy. 29. 262-269. Julie’s research on improving gross motor skills in children with Autism Spectrum Disorders received Northeastern’s RISE award in 2016. In their practice, both therapists focus on a collaborative team approach to improving motor performance in children with ASD.

Attendees were given a comprehensive review of Autism Spectrum Disorder, including the DSM-V (2013) diagnosis as a Neurodevelopmental disorder. We learned that ASD is no longer classified on a “spectrum” but with levels of severity. The term “Asperger” is no longer used, but individuals with the characteristics formerly attributed to Asperger are now considered to be “high functioning Autism.” An alarming statistic they revealed was that currently 1.5 billion children in the US have an autism diagnosis. Jenn and Julie cautioned that diagnosing ASD is complex and in the past 5 years, neuroimaging has provided startling information about the difference in the brain of the child with ASD from a typical child, i.e. “neuro over connectivity” that impacts function.

Jenn and Julie addressed the fact that motor function of children with ASD is affected, usually with simple motor tasks being intact, but with complex tasks and motor planning being impaired. Motor difficulties are now considered a “Core Deficit.” Screening for motor deficits is important for all children with the ASD diagnosis. The PT’s role includes recognizing if a motor impairment interferes with function. Julie and Jenn cited a number of studies that examined how core deficits affect a child’s participation in physical activity across many dimensions. What we might see is a child who prefers simple, sedentary activities and who doesn’t participate in complex social activities such as organized sports. In summary, motor deficits affect a child’s ability to participate in play.

When providing treatment for the child with ASD, Julie and Jenn advocate strongly for a team collaborative approach that includes the child’s family members. They noted that the ABA therapist would be a strong, valuable ally because they can provide behavioral support to motor intervention. They discussed ways to design the environment and treatment sessions in order to help ensure success and motor learning. A few examples they gave were: promote positive transitions, simplify choices, and have a predictable space and schedule. A few materials they recommended include: Body Awareness Fun Deck, Upper Body and Core Strength Fun Deck, Magicatch Set, Rainbow River Stones, Learn to Move, Move to Learn!, and ABC Yoga Cards for Kids.

We are grateful to Jenn and Julie for sharing their passion and expertise for improving motor performance of children who have an ASD diagnosis. With improved motor skills, it is likely that other areas of function will be affected in a positive way as well. With the high incidence of ASD worldwide, Autism will affect us all. The need for continued research is critical to help our understanding and ability to treat children with ASD effectively.

Here are just a few of the attendees’ positive reviews of this seminar:

“Incredibly informative and relevant! Felt so empowered from the seminar. Helped to give me better direction in my practice as well as increased confidence in my recommendations to families & school staff.” – Laine F., Physical Therapist

“The two presenters were so knowledgeable in their area – facts were most interesting.” – Rolene K., Teacher

“Great overview of school PT and best practice for collaboration with all members of the team.” – Micaela M., Physical Therapist

“Presenters were professional presenting evidence based practice to help improve functional skills for students with Autism.” – Alice T., Occupational Therapist

Thank you, Jenn and Julie!

Filomena Connor, MS, OTR/L
January 12, 2018

Teresa A. May-Benson, ScD, OTR/L, FAOTA, is a pillar in the field of sensory processing disorder (SPD). She is the Executive Director of the Spiral Foundation (Sensory Processing Institute for Research and Learning), whose stated mission is “To Increase Understanding and Acceptance of Sensory Integration and Sensory Processing Dysfunction through Education and Research.” Dr. May-Benson is an esteemed educator and researcher as well as a clinician at OTA The Koomar Center in Massachusetts. At today’s Saturday seminar entitled: ASHs to A/ASPs: Comparison of Assessment Tools for Adolescents and Adults with Sensory Processing Disorder, she provided a comprehensive review of available assessments for the adolescent and adult populations with accompanying research, as well as a detailed overview of her tool, Adult/Adolescent Sensory History (ASH), published in 2015.

Dr. May-Benson reviewed research studies conducted on adults with SPD and concluded that there is a paucity of research and more is needed. She outlined what we currently know about SPD in adults, including how it impacts all aspects a person’s life. A poignant example she described was a mother who is sensory defensive who had difficulty maintaining a family relationship with her child who is a sensory seeker. The challenge for therapists during the process of assessment is to explore what things are affecting the person’s ability to engage in life activities. Dr. May-Benson also cited the problem of an apartment dweller who is auditory defensive and lives in an apartment in between two apartments. Moving to an apartment end unit that has extra insulation from noise may be a good solution to explore with this client. These examples demonstrate the value of an interview as part of the assessment process because it helps the therapist gather information about the individual’s daily life experience, along with formal screening and direct assessment.

There are a number of tools available to assess SPD that Dr. May-Benson reviewed, discussing their positive aspects and their limitations. She cautioned that screening tools should be used only to determine whether a sensory-based problem is present that warrants further testing.

According to the Spiral Foundation, “The Adult/Adolescent Sensory History is designed as a self-report assessment of sensory and motor behaviors commonly observed in individuals with difficulties processing and integrating sensory information. The purpose of this assessment is to help identify adults and adolescents ages 13 to 95 who experience problems in sensory processing and integration as well as assist therapists in clinical reasoning when creating interventions for these individuals. Based on the conceptual model of sensory processing and sensory integration proposed by A. Jean Ayres, this measure is designed to identify difficulties in five key areas of functioning: Sensory Discrimination, Sensory Modulation, Postural-Ocular Skills, Praxis, and Social-Emotional Functioning.” The ASH has performed strongly on tests of reliability and validity. It is available at the Spiral Foundation www.thespiralfoundation.org This website offers many resources including webinars, courses, and free SPD education toolkits.

In her presentation, Dr. May-Benson provided the following implications for practice:

• Assessment of adults with SPD is complex and should be comprehensive.
• To determine sensory integration difficulties, assessment must include more than questionnaires.
• Be aware that different measures emphasize different aspects of sensory integration; be aware that we may miss vital information if we use one measure over another.
• Select measures with the particular client’s needs.
• Recognize that all measures are not created equal: some measures can provide better functional performance information than others and others may provide better psychometrics than others.

We were honored to present Teresa May-Benson’s seminar to spotlight her diligent work over the past 15 years to develop the ASH, which is a comprehensive, valid and reliable adolescent/adult assessment of SPD. Her research has illuminated the issues that clients with SPD as well as their families and practitioners face. Her research is ongoing and crucial.

Here is a sample of positive reviews about Teresa’s seminar:

“Excellent overview of Sensory Assessment tools.” – Teri B., Occupational Therapist

“I would recommend this seminar to a colleague if they work with an adolescent or adult population. The ASH appears to be a useful tool.” – Anonymous, Occupational Therapist

“Thank you for a well-organized and comprehensive seminar about the tools available for adolescent and adults with SPD. Teresa’s new assessment tool has great potential!” – Maria K., Occupational Therapist

Thank you, Teresa!

Filomena Connor, MS, OTR/L
December 15, 2018