Category Archives: Therapist Resources

Comprehensive resources, strategies, and tools designed to support therapists in delivering effective care and ongoing professional growth.

Back to School Bootcamp: Strategies for School-Based OTs

School-Based Practice, Therapist Resources,

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

Integrated Learning Concepts: Reflex Integration for Postural & Ocular-Motor Skills

School-Based Practice, Sensory, Therapist Resources, , ,
June Smith, OTR/L’s presented the Saturday Seminar Integrated Learning Concepts: Practical Strategies to Promote Reflex Integration with Postural/Ocular-Motor Based Learning

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

Motor Interventions in Autism: Enhancing Participation and Function

Events & Conferences, Motor & Movement, Therapist Resources, ,
Dr. Jennifer Colebourn, MSPT, DPT and Dr. Julie Goff, MSPT, DPT presenters of The Role of Motor Interventions in Autism Spectrum Disorder.

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