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      • has more difficulty than other children with self-care activities such as: tying shoes, getting jackets on/off, toileting, set-up or clean-up of lunch;

      • avoids or refuses to complete center craft activities;

      • exhibits behaviors that are not age appropriate when doing independent work (tantrums, making loud noises with mouth, getting up frequently to sharpen pencil during the time allotted);

      • does not initiate speech or social interactions with other students;

      • cannot re-tell a story or provide details after reading a passage;

      • has difficulty navigating stairs, gym class, and hallways;

      • cannot transfer from place to place without falling;

      • avoids learning new skills and skills in the classroom;

      • has difficulty walking in line or being close to children;

      • does not participate in recess and gym activities;

      • has difficulty organizing desk and homework materials;

      • demonstrates increased difficulty copying work from the board;

      • forgets assignments or seems disorganized;

      • difficulty with handwriting, using a pen/pencil, forming letters and numbers, forming cursive letters;

      • has trouble with the use of tools such as scissors, hole punchers, staplers;

      • demonstrates frequent tantrums when tasks are difficult;

      • places objects in mouth frequently such as clothing, classroom items, toys;

      • has difficulty with following commands or classroom routines;

      • does not know left from right;

      • avoids getting messy with items such as glue and paint;

      • difficulty sitting still and seems in “constant motion”;

      • has trouble making friends;

      • seems to get lost easily in the school building or when transitioning between activities;

      • difficulty playing independently at recess or reckless/impulsive behavior;

      • difficulty maintaining upright posture in her chair or during circle time;

      • has visual-spatial trouble.

      The list above is not exhaustive, but is meant to show examples of what difficulties a student may have. Remember that there are many variations in the time each child acquires skills. For example, if a child has a condition affecting his development, there may be a discrepancy between his actual age and his functional age levels. For example, it is important to note if a particular child is performing academic work well beyond his age expectations, but needs extra help to make friends or remember classroom routines.

      Difficulty with activities of daily living (ADLs) are often an indicator of the need for additional therapy. Things such as re-dressing after toileting, blowing nose, opening/closing containers, using toilet, washing hands, opening/closing doors, putting on/taking off jacket, managing backpack, walking, navigating stairs or gym class, setting up lunch and feeding self independently are all activities that a child is required to do independently in school. Remember, these skills may be emerging for pre-k and kindergarten students. Teachers are wonderfully insightful as to whether or not skills are developing appropriately in the classroom.

      What Is Occupational Therapy?

      Occupational therapists (OTs) are critical members of the team in both medical and school settings. OTs work to ensure the student can perform activities of daily living as independently as possible. There are several areas in school where OTs can make a significant impact. Through a thorough evaluation in areas such as: fine motor, strength, vision and perceptual skills, sensory processing, and more; goals will be developed specifically for your student. Areas that are also considered include: overall transition skills, direction following, organization, attention, and self-care as it relates to education. The time an OT works with a student directly depends on the time that the team determines is necessary to participate in his education with the appropriate accommodations and supports. When parents, teachers, therapists, and students are aware of the tools available to them, it is beneficial to everyone in building the best educational plan. OTs are part of the “related services” category – part b in the Individuals with Disabilities Education Act.

      What Are Some Common OT Goals in the School Setting?

      In addition to the list of activities in the previous section, many districts are recognizing the importance of SPD (sensory processing disorder) and its impact on a child’s daily routine. Here is an example of an OT goal which would cover SPD relating to a child’s educational needs: By the end of the IEP date, Jacob will demonstrate the ability to regulate his body for quiet work tasks by choosing an appropriate calming down activity 90% of the time. The therapist may teach Jacob how to monitor his level of “alertness” with a program such as How Does Your Engine Run? ® by Shelly Shellenberger and Mary Sue Williams (www.alertprogram.com)⁴. Further, he may then learn which activities in the program are calming to him vs. causing him to become more active when he and his peers are doing quiet work at their desks. I have created a series of activity cards or sensory break cards on my website which are inexpensive and easy to download, print, and laminate. They are colorful and a great visual reminder for students with and without special needs! (www.pocketot.com, under the “shop” tab)

      Here are some sample annual goals in an IEP:

      • In a one year period, Mary will stabilize the paper with one hand while drawing and writing to compose language arts lessons 75% of the time.

      • By the end of the IEP, Victor will be able to isolate a finger to push a button, keyboard, mouse, etc. to type 26 out of 26 lowercase letters 100% of the time in ELA class.

      • At the end of the IEP period, Jennifer will demonstrate the ability to hold her writing utensil with a tripod grasp during writing class 75% of the time as evidenced by data collection by OT.

      • In one year, Joshua will demonstrate the ability to use proper spacing between words during ELA class when writing 90% of the time.

      • Billy will be able to copy math assignments at his desk to record 100% of the assignment during this IEP period.

      • Jeremy will complete math tasks regardless of external visual stimulation 70% of the time, by 1/2/16.

      • When frustrated during science lessons, Virginia will use relaxation techniques to regulate arousal level 90% of the time, according to data collected by Ms. Jones.

      Every goal needs to note who is collecting the data and monitoring the progress. The goals we write need to be measureable and they need to be given a time frame (the annual IEP period for long-term goals). The goals need to be broken down into smaller, more measureable goals. They are called “short-term goals (STG).” They are like steps which show progress toward the long term goal. Here’s an example:

      The long-term goal will be: In one year from the date

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