ILOTA Communique July/August/September 2018 | Page 12

July / August / September • Issue 3 • 2018 Colleen McDonald, OTR/L School-Based Practice: Developing a Sensory Equipment Lending “Library” If a student is rolling around on the carpet during circle time, isolating herself and covering her ears, or having a tantrum when asked to sit down and work, special education professionals in the school system may turn to the occupational therapy (OT) practitioner and ask whether some kind of sensory intervention would help. As OT practitioners serving our area’s public and private schools, my fellow therapists and I do our best to keep up with current research and best practices regarding the use of sensory equipment and sensory strategies to improve our students’ ability to focus, participate, and learn at school. However, a couple of years ago we recognized that we were not doing a good job of keeping up with our equipment needs. We would start the school year fairly well-stocked with kinesthetic seat cushions, pressure vests, weighted blankets and lap pads, and other common sensory tools; available to be checked out from our therapy department “headquarters.” However, as the year wore on, our supplies would dwindle, as the equipment went out to our various schools and to students who might benefit from using them. Equipment that “worked” (helped students meet their goals) would no longer be available for circulation. Also, equipment that was not being used on a regular basis might stay in certain buildings (particularly those with special programs for students with autism), so that it would be readily available to students with documented sensory needs. As the school year wore on, many of us found it increasingly difficult to locate high demand equipment to use or try with move-in or newly eligible students coming onto our caseloads in the course of the year. After this problem had surfaced and resurfaced at a number of staff meetings, our department decided to form a special interest group to evaluate the situation and come up with a new plan. The voluntary group included therapists who were frustrated with the problem and wanted to be part of the solution, as well as autism specialists who had ordered many sensory tools over the years and could offer their insights as to which products were most effective, and which products were not worth the money. The process began at the end of that school year, with a call to bring back all the equipment that was not assigned to a particular student. Over the summer, equipment was washed, repaired, or thrown away. Starting in the fall, the special interest group met regularly, came up with an action plan, and developed a new system. The group did an inventory of the equipment on hand and assessed the need for additional equipment. After identifying various categories-- such as oral motor tools, hand fidgets, and weighted equipment—each member of the group named particular pieces of equipment that were “most necessary,” with a rank ordering of priorities within each category; these individual lists were then shared with the whole group, for a decision about what additional pieces of equipment the group would order, within the allowed budget. The group decided they wanted to provide teachers with written instructions regarding the use of the equipment. Group members researched protocols and precautions for major items such as pressure vests and weighted blankets, and discovered that protocols sometimes varied across different websites. They discussed the differences they found and then came to consensus about which protocol they would use. Further, they developed a “user friendly” data collection form on which teachers could provide feedback by indicating when a piece of equipment was used, and to what effect (positive, negative, or no change). To launch the new system, the group decided to take the sensory equipment out of the general supply room and put it in its own, marked cabinets. They re-worked the check- out routine, so that, within 3 weeks of checking out a piece of equipment, the borrowing therapist would be expected to make a preliminary decision about whether it was benefitting the student—and, if not, to return it (the exception being hard-to-sanitize oral-motor tools, which we do not re-use with other students); or, if it was helping, to order a replacement to go back into the general supply. They also put together an eye-catching check-out binder, which included a master list of our equipment, guidelines detailing the check- out process, equipment sign-out sheets, instruction and data forms for teachers, and order forms and ordering information (with preferred vendors) for replacing equipment. Continued on Page 13 Page 12