1. 10/10/2015The Childrens Therapy Center1 Integrating Therapy Into The Classroom Cara Rogerino Cara Rogerino Diane Callari Amanda Crosetto Lori Zozzaro

2. 10/10/2015The Childrens Therapy Center2 What is integrated therapy? Integrated therapy is providing therapy to a child within the context of what the child is doing in the classroom or natural environment. This model promotes social competence generalization and consistency. Adapted from www.fpg.unc.edu/~inclusion

3. 10/10/2015The Childrens Therapy Center3 What does this mean for our classroom? “Integrated therapy is the coordination of therapy or consultative special education within the ongoing routines of the classroom. While the therapists are working with the child and classroom teachers in the classroom, those teachers have the opportunity to see what the therapist does with the child and implement those same strategies into the rest of the week when the therapist is not present. When therapists and teachers work together to provide services and education to a child, the child benefits by receiving well-coordinated intervention.” Taken from www.vanderbiltchildrens.com

4. 10/10/2015The Childrens Therapy Center4 Video n Therapy in Circle Time n Perspectives in Inclusion

5. 10/10/2015The Childrens Therapy Center5 Team Member Roles Teacher n Organizes/plans class schedule n Delegates staff and roles n Coordinates with therapists n Monitors carryover of therapeutic strategies in class n Open to suggestions and constructive criticisms from team members Speech Therapist n Creates functional picture vocabulary for class routine n Aids and models appropriate use of augmentative communication devices n Available for consultation every day in the classroom during feeding sessions n Inservices for classroom staff (e.g., oral-motor, sign language, feeding) Occupational Therapist n Incorporates self-care skills into daily routines for each child (e.g., dressing, feeding, brushing teeth, washing hands/face) n Advises and provides adaptive equipment for fine-motor tasks during class activities n Incorporates sensory strategies into daily routines for children as needed n Consultation with staff regarding positioning and equipment Physical Therapist n Consultation regarding transitional movements, ambulation, and use of equipment n Positioning (with/without adaptive equipment) n Adapting classroom activities to meet the physical needs of each child

6. 10/10/2015The Childrens Therapy Center6 Benefits of Integrated Therapy n Provides many opportunities for the child to practice new skills in naturally occurring activities or interactions n Prevents disruptions in the child’s daily routine n Prevents time when the child is removed from the presence of his/her peers n Allows teachers/staff to observe therapists using techniques and to learn new approaches for developing and improving the child’s skills throughout the day n Allows therapists to observe the child during classroom routines which leads to developing goals which are useful and interesting for the child n Encourages collaboration among parents, classroom staff, and therapists to develop useful goals to address the child’s needs n Provides opportunities for teachers to get new ideas for inclusive activities Wesley, P.W., Dennis, B.C., & Tyndall, S.T. (1998)

7. 10/10/2015The Childrens Therapy Center7 Our Observations n Carryover of therapy skills into classroom environment n Increase in use of AT devices n Increased focus on function during therapy sessions n We have a more realistic perspective of achievable goals within the classroom environment n Greater motivation for children to participate in therapy when they are with their peers n Increased social interaction between students n Teacher and staff gain better understanding of therapeutic strategies and become more confident in carrying them over n Rapport with students and staff established earlier in the school year n Transitions seem to be easier and less stressful for students since they are being pulled out of the class less n Children are not missing out on classroom lessons n Adaptation of classroom materials occurs in the moment, when it is needed for each child during a classroom activity n Skills are addressed within the context of the school day, rather than in isolation. Therapeutic goals/skills are being addressed in naturally occurring instances during the school day (e.g., working on dressing by taking a coat off after arriving at school or working on transitioning from sitting on the floor to standing after yoga) n Children are able to stay on task better as there are fewer disruptions/distractions in the classroom (e.g., therapists entering the class throughout the day to pull kids out) n More opportunities to work on a skill because it is embedded within the daily schedule n Increased collaboration and communication among teacher, therapists, and classroom staff in regard to goals, reports, activities, etc.

8. 10/10/2015The Childrens Therapy Center8 Review of Literature n Therapy and instruction should occur in the child’s classroom (Giangreco, York, & Rainforth, 1989) n Other children should be present during therapy and instruction (Wilcox, Kouri, & Caswell, 1991) n Therapy and instruction should be provided as part of ongoing classroom routines and activities (e.g., Miller, 1989) n The child’s initiations should be used as the primary context for therapy and instruction (McDonnell & Hardman, 1988; Warren & Kaiser, 1988) n Therapy and instruction goals should address behaviors that are immediately useful for the child (McDonnell & Hardman, 1988; Norris & Hoffman, 1990) n A primary role of the external therapist or special educator is as consultant to the child’s regular teacher (Johnson, Pugach, & Hammitte, 1988) Adapted from McWilliam, R.A. & Bailey, D.B. (1994)

9. 10/10/2015The Childrens Therapy Center9 Review of Literature n Woler, M., & McWilliam, R. A. (1998) –Integrated therapy found to be marginally more effective than segregated therapy in affecting child outcomes –Effects on service delivery (rather than child outcomes) are more promising: n Classroom staff communicate 4x more often when integrated therapy is used rather than segregated approach n Teachers like integrated therapy better than pull-out therapy n Teachers know children’s IEP goals better when therapists use integrated models rather than segregated models –Evidence that practitioners want to provide more integrated services than they typically do –Authors’ conclusion: “the simplest rationale for integrating therapy is that it should result in the child’s receiving more attention to individual needs, via follow through by the teacher, than the child would receive through traditional segregated therapy.”

10. 10/10/2015The Childrens Therapy Center10 Suggestions for Implementation n Be flexible n Integrate yourself into the classroom – become part of the classroom team n Communicate with teacher and other therapists n Observe the classroom to familiarize yourself with the routine and see where you can address your goals/objectives n Designate time for weekly team meetings specifically to discuss planning – at least one hour per week. n Be open and willing to answer questions from classroom staff n Follow the teachers lead and adapt therapy activities according to the lesson and environment