Embedding participation in schools: embracing the Partnering for Change (P4C) model in London © Missiuna, Pollock, Cambell, Levac and Whalen, CanChild, McMaster University, 2016

Universal Design for Learning (UDL) Equal access to learning Enhanced capacity of all students Remove barriers that prevent participation “Good for all, essential for some” Multi-sensory approach Posture poems Different scissors on tables Movement breaks Classroom furniture Grading activities Co-teaching www.cast.org

How have we been doing it? Pilot Project First Year 2015-2016 4 schools 4 therapists Focus on UDL Pilot Project Second Year 2016-2017 9 schools 8 therapists Pilot Project Third Year 2017-2018 7 therapists Full model RCOT 2014 Hutton et al 2016

How do we plan and measure? Pollock et al. 2017

What have we been able to measure? 135.5 hours of whole class activities, reaching 1038 students = 10% of primary school aged students in Camden Termly meeting with SENDCO Training Individual strategy trial Classroom environment advice Teacher liaison Whole class activity Observations

What do the teachers and SENDCOs say? The project enables early identification of children who need extra support. It also give the class teacher valuable ideas that she can build into her own teaching. I believe that is a really great way of sharing the OT’s expertise and in the long run it will provide more support for more children Identifying children; immediate implementation of ideas/ interventions The impact is wider than 1:1 work and is sustained. It supports whole school working in addition to individual children It builds up staff knowledge and you have an OT with real expertise visiting the school on a regular basis

Challenges Changing from a caseload to workload mentality Collaborative consultation Time to meet and plan with teachers Linking with parents Outcome measures Wintle et al. 2017 Looking at offer to all maintained local authority schools Reviewing impact and outcome measures

Steal… Regular days/times so that school staff know when to expect you Explaining rationale for recommendations Choosing the right time to share knowledge Peer support Whose goals are they? How is your workload & time distributed? Carry out assessment and strategy trial in context Coaching, problem solving approach using guided discovery Shana Boltin Lead OT for Mainstream Schools Team Royal Free London shana.boltin@nhs.net @RFHPaediatricOT

References AOTA 2014. Transforming Caseload to Workload in School-Based and Early Intervention Occupational Therapy Services. https://www.aota.org/- /media/Corporate/Files/Practice/Children/Resources/Transforming%20Caseload.ashx Campbell WN, Missiuna CA, Rivard LM, & Pollock NA (2012). “Support for everyone”: Experiences of occupational therapists delivering a new model of school-based service. Canadian Journal of Occupational Therapy, 79(1), 51-59. Hutton E, Tuppeny S, and Hasselbusch A (2016). Making a case for universal and targeted children's occupational therapy in the United Kingdom. British Journal of Occupational Therapy, 79 (7), 450-453. Missiuna CA, Pollock, NA, Levac, DE, Campbell WN, Whalen SDS, Bennett SM, Hecimovich CA, Gaines BR, Cairney J & Russell DJ (2012). Partnering for change: An innovative school-based occupational therapy service delivery model for children with developmental coordination disorder. Canadian Journal of Occupational Therapy, 79(1), pp.41-50. Pollock NA, Dix L, Whalen SDS, Campbell WN, & Missiuna CA (2017). Supporting occupational therapists implementing a capacity-building model in schools. Canadian Journal of Occupational Therapy, 84(4-5), 242 – 252. Wintle J, Krupa T, Cramm H, & DeLuca C (2017). A scoping review of the tensions in OT–teacher collaborations. Journal of Occupational Therapy, Schools, & Early Intervention, 10(4), 327-345, doi: 10.1080/19411243.2017.1359134 Witmere K (2002). The evolution of school-based speech-language services: A half century of change and a new century of practice. Communication Disorders Quarterly, 23 (2), 68-76, doi: 10.1177/152574010202300202.

What have we been able to measure? 135.5 hours of whole class activities, reaching 1038 students = 10% of primary school aged students in Camden

Caseload  Workload Mentality Number of CYP allocated Number of intervention sessions during a given time period Medical model Workload All the work activities that benefit students directly & indirectly Relates to RtI service model AOTA 2014