Posted in Eleanor Cawley, M.S., OT

Creating Digital Notebooks

Reduce frustration for you and your child

Organization Group NewsIt is difficult for some students to get through school well organized.  Parents, teacher and even students become frustrated with missing homework assignments, notes out of order torn or even missing altogether.  When frustration ensues, it is easy to become argumentative, which is counter-productive to getting work done.

It is my goal to support your efforts to help your child by taking that task over. Creating digital notebooks with your child, there is little worry about losing important work.

Children with Executive Function Disorder have difficulty performing “activities such as planning, organizing, strategizing, paying attention to and remembering details, and managing time and space. ”

Using technology I can help your child manage all that paperwork and not feel so frustrated.  Just think, once a document is loaded into the correct digital notebook, it will never be lost.  If your child loses a paper document that has been uploaded, all he or she needs to do is print out the document.

When teachers request that the student present a notebook, the notebook can be e-mailed to the teacher.  If the teacher will not accept a digital form of this notebook, the notebook can be printed.

Notebooks will be available, in real-time, on the web allowing access in any location with an internet connection by simply using a log-on and password.

Less frustration for all makes home and school life smoother. Please feel free to call for further information.  631-629-4699

 

Posted in Eleanor Cawley, M.S., OT

So Why Should Occupational Therapists Bother to Write Rubrics?

Mostly, therapists read my posts on social media and then move on. Some comment positively and others, not at all. But then there are those times when there  is that one person who challenges you. I must say, that one person tends to get my fight on! I feel that I have to prove my work all over again. But I really love the debate. To those of you who feel that rubrics are not necessary, that’s okay. However, I feel they are.
Rubrics have been around for a very long time. During my research for my book, “Using Rubrics to Monitor Outcomes in Occupational Therapy“I found that rubrics actually began not in the educational field but in the medical field, decades ago. I feel that rubrics were lost in the shuffle in part due to the changes in the provider/client relationship, moving from power over to power with and ultimately to power through our clients. Now that we are searching for ways to become more ‘client-centered’ as a profession, I feel that transparent, understandable documentation is the key.

It has always been our premise, as occupational therapists, to have our clients engaged in purposeful activity. With the increasing intrusion of third-party payment systems into what we do with our clients and the struggle to become ‘client-centered’ having a method of recording progress becomes increasingly important. Yes, of course, we need to get paid for our work but we also have an obligation to our clients, any one receiving our services.

We all have those people, who question what we do.  I am sure that each and every one of us has had this experience.  Sometimes we can explain what is going on, through statements based on clinical knowledge, but then there are other times that we need real data.  Some challengers will accept the “+” or “-” system of data collection [“+” yes the client was able to perform the task or “-” no the client was not able to perform the task]  while

 

My Book Cover2
Enter a caption

others want more information.

So rubrics offer us a method of documenting some of our thought processing with regard to critical thinking, clinical reasoning and judgment. Sharing rubrics with clients and caregivers provides them with a tool to engage them in the treatment process in a way that is greater than just sharing goals.  By encouraging clients to monitor their own progress they become more vested, more engaged and more accountable to themselves and to us, their service providers, ultimately leading to greater gains.

Rubrics may be initially time-consuming to learn and to write, just like any other skill, the experienced therapist will soon be developing rubrics a lightening speed and have at their disposal a wealth of data and documentation supporting our services.  In my humble opinion, if a therapist chooses to use or not to use rubrics, it is okay, it’s their decision.  I choose to use rubrics, engage my clients in progress monitoring, and have data specifically highlighting the client’s progress.  In my opinion, how can I expect my clients to make the best progress if I do not share my expectations with them. I feel that I empower my clients through the use of rubrics, because I want to, not because I have to.

 

 

Posted in Eleanor Cawley, M.S., OT

Revisiting The Student Interview

The Student Interview CoverAI have worked with middle and high school students most often.  At this age, a student’s frustrations increase proportionally to the workload.  They are aware of what works and what does not work for them.  When frustrations run so high and parents begin to panic, it is at this time other professionals, advocate and lawyers, become involved.

The Student Interview was developed because of a number of school-based cases that I had been involved in were quite intense.  Every small detail of the case was explored in depth.  I felt that it was imperative that the student have a voice and that I had a document that asked all the right questions. While it is very sad to see the state of the educational system, as it is right now, I feel that the educational system is in transition.  There are always ups and downs when experiencing a transition.

Over the last few years, I have used this interview with many students.  Since this is a form to complete, it is good experience for a student in the transition process.  There is a variety of questions, relevant to the student’s educational, vocational and self-care needs.  Some questions require a yes or no response, while others are open-ended and call for more detail.  The Student Interview serves its intended purpose quite nicely. Since using The Student Interview, I have not had that “uh oh” moment when something comes up that I should be aware of.  At least nothing that I have not at least asked and have a response to.

I really love a student’s surprise when he or she is asked to complete the satisfaction survey.  This is often the very first time a student is asked for his or her opinion on services.  I, now, provide each student with this interview.  I find it an invaluable tool not only as written documentation but also as a basis for a deeper conversation regarding a student’s skills, and their perceptions of themselves.

 

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings, Occupational Therapy

When Is It The Time To Recommend Assistive Technology For Note-Taking?

I must state, before anyone reads this, that I am a HUGE fan of using assistive technology.

I recently read a comment about a piece of technology not being “cool.”  I realize that there are students who will never feel “cool” when using assistive technology.   I also feel that students must be taught touch typing and the basics of functional programing before being asked to take notes using assistive technology.  It always boggles my mind when some recommends a piece of assistive technology, such as an Alpha Smart, without ever considering if it will really work for the student.  Many students consider an Alpha Smart to be ‘uncool’ for the following reasons:

  1. Looking different from peers
  2. Not knowing how to use the device
  3. Still not being able to keep up
  4. Fumbling with the technology in front of others

In my humble opinion, students need time to learn how to use such a piece of equipment or a program.  One of the reasons that a student might need the technology is due to an inability to handwrite legibly.  Another might be difficulty organizing thoughts and motor movements.   Assistive technology needs to be worked on privately with the student or in a very small group with other students using similar technology.  Every aspect of using that device and the skill that it is supposed to support needs to be worked on prior to giving this device/technology to the student to use in the real world.  For example, when providing an alternative keyboard to a student to use to take notes the following needs to be explored:

  1. Can the student take notes without the device even though his or her handwriting may be illegible to others?
  2. Does the student know the verbal cues that would trigger him or her to start taking notes?
  3. Is the student capable of taking dictation either written or using a keyboard?
  4. Can the student use those verbal cues to format notes?  If a student hears the terms “Pros and Cons” or the word “conversely” does the student know that this may be a great time to use a T-Chart style of notes?
  5. Can the student attend to the instructor long enough to follow the lecture?
  6. Is the student familiar enough with the keyboard to type at least 30 words per minute over the length of the class for note taking?
  7. Can the student use punctuation to help the notes make sense with any degree of success?
  8. Is the student comfortable enough with keyboarding in a room full of other students, who are not using a keyboard, to be successful?

Obviously, I could ramble on and on.  We need to think, “When is an alternative device or program better than the low-tech copy of notes provided to the student?  The technology that we supply is only as good as the support that we give to the student.  If we jump to provide assistive technology to a student without looking at the student’s overall ability to succeed without the device, then are we sabotaging the student to dump the device or program and throw in the towel?

I feel that note-taking should be a skill taught in every school, to every student.   A task analysis of note-taking skills needs to be completed and the student assessed using that analysis before providing a device.  The organization of the page should come before the thought of using an assistive technology device or program.  The language that we use in the classroom should trigger a particular format of notes.

There is so much learning that needs to be done by each and every student.  Students are getting frustrated and need to have a place, a structure to go back to.  At that point, once the structure has been taught and reinforced and the student is not yet successful, then and only then should a device or program be considered for taking notes.

I know that every teacher that I come in contact with is working day and night to help all the students learn everything they need to.  I know that many provide notes, study guides and review materials to students, hoping that somewhere, sometime, something will work at some point.  I think that those of us working with students need the structure, the organizational hierarchy, to assess a student’s abilities just like our students need to learn.

Posted in Assistive Technology, Eleanor Cawley, M.S., OT, New Beginings

Assistive Technology Assessment

Thinking in Terms of Developing Skill Sets Rather Than Compensating for a Disability

There are many types of assistive technology evaluations including:  mobility, seating/positioning, communication, computer access, switch-access, and aids for daily living, work-site modification, home modification, and recreational assessments.  While assistive technology should be considered in the typical ways; it should also be considered in other ways, i.e., development of skill sets.

From the use of smart phones to navigating the community, developing visual picture schedules to support a cooking or grooming task to the use of laptops and desk top computers for literacy programming, assistive technology supports the development of skills or skill sets.  [Assistive] Technology is here to stay.

Students who are unable to develop skills similar to their peers may very well be more capable with the use of technology.  The Cloud, iPads, iPhones and tablets make taking notes and organizing those notes much easier [with training] increasing a student’s ability to be independent.  Using literacy programming may actually provide a student a voice where he or she did not have one before.  Using technology successfully has the potential to help a student develop confidence and self-esteem.

What makes the addition of developing a skill set different from the typical assistive technology evaluation?  First the referral is targeted toward a specific reason for that referral.  All of the same criteria for that typical evaluation are assessed.  The same programming and devices are explored as is the student’s responses.  Each teacher working with this student is provided with a questionnaire and interviewed based on those responses.  This then gives the evaluator a picture of the student and the skills required to meet the demands in each core class.  A clearer picture of the student’s abilities to achieve the desired skill set is then established.

Based on the demands of that particular skill set, the student is observed discreetly in a core class.  For example, if the desired skill set is to take notes, the following skills will be explored and data collected:  responses to sight and sound, orientation to the teacher, motor response to cue words, quality of the notes taken (content, legibility and organization), etc.  Based on the data collected, recommendations are then made to help the student reach the goal of the desired skill set.  This may be almost a full day of assessment for a particular student.

Once recommendations have been made, and the report has been submitted to the district, the real work begins.  It is important for the evaluator to be in contact with the district’s technology team.  Together with the technology team, a device can be prepared to meet the student’s needs in each of his or her classes.  In the case of note taking, it may mean that a device must be in sync with the Smart Board in class so that the student can save the lecture notes.  Different programs, based on teacher preference, may also need to be learned by the student to ensure that the notes are recorded.

So after a full day of evaluation, and further consult with the technology department, it is prudent to set up additional consult sessions to train the student and the staff in the use of the device, develop future goals and assess whether or not this plan of action will be successful for the student.  In order for assistive technology to meet the needs of the student, it must be constantly assessed and re-assessed, with additional support to the student.

In a different scenario, a student may be recommended for an assistive technology evaluation to address poor handwriting skills.  In addition to the typical assistive technology evaluation where the student’s keyboarding ability is assessed, he or she may need additional support in keyboarding using a touch typing method to improve speed and accuracy.  Often a student with poor handwriting skills has been provided with a computer as needed but he or she has not learned the correct method of keyboarding.  This leads to greater frustration and disenchantment, with any device provided, due to a higher error rate.

A traditional assistive technology evaluation may be requested if the student has reading difficulties, for example, Dyslexia.  Options for assistive technology include text to speech programming-having text from a computer read to the student in a computer voice.  Once the student has been approved for assistive technology, depending on the programming chosen by the district, the voice in the test to speech program can be somewhat pleasing or definitely irritating.  It is difficult to train a student to to modify and use this type of programming during the initial evaluation.  Digital book sharing services require that the student have an account.  This account needs to have a completed application, parent consent and a sign-off by a professional to indicate a visual print disability.  It can take a day or two for the company to approve the application.  Upon approval, a Welcome e-mail is sent to access the account.  Often, an additional program needs to be downloaded before the student or parent can download books to read.

There is a significant delay in the student accessing and using this programming.  If the teacher has not had access to digital book sharing prior to this student, he or she also needs to learn how to use the programming.  So in addition to the evaluation and initial training, follow up and ongoing training is necessary.  This training can be done by the evaluator or district personnel knowledgeable in this area.

In general, assistive technology can only be considered successful if the student is using it to function within his school and home environments and is able to perform the activities with an increased level of independence.  This brings attention to another issue that arises with the use of assistive technology, which is caregiver training.  Frequently, in this training loop, the parent [or caregiver] is left out.  It is important to have the parent participate in at least one training session, once the technology, approved by the district, is in place.

It is ny goal to ensure that every student receiving assistive technology, either through the district or through private funding, receive the training that he or she needs to gain independence.  Once again, if the student is not comfortable with the technology or does not fully understand how to use it, the technology is wasted as is the money spent or the evaluation, purchase and training.  We must also be very careful in not allowing the assistive technology provided being considered another failure.  This can further undermine a student’s self-confidence and self-esteem.