Occupational Therapists' Role in Addressing the Issue on Sitting Too Much in the Classroom

Issue

The issue in this new article is an issue that has been a hot topic recently: “Why Kids Shouldn’t Sit Still in Class. This article talked about the need for children to move throughout the day and how evidence is showing that activity breaks during the day help children learn and be more attentive. The article mentioned several references to why movement during the school day is important for children. It mentioned the use of “GoNoodle”, which is a classroom movement program, and how it’s used in several classrooms. However, due to time constraints and the shift into focus on standardized testing, we are not thinking about providing students with “play” during the day. I believe that a policy needs to be put in place for providing movement throughout the school day for children, so they have the potential to learn for effectively and be more attentive in the classroom.

https://www.nytimes.com/2017/03/21/well/family/why-kids-shouldnt-sit-still-in-class.html?utm_source=huffingtonpost.com&utm_medium=referral&utm_campaign=pubexchange_article

Service Delivery

This service needs to be addressed delivered through the educational system in a collaborative effort. This is the quickest way to get to our teachers, who would be responsible for implementing movement breaks throughout the day. However, teachers are too busy to address this as they are already focused on providing effective ways to educate their students. Occupational therapists were surprisingly not mentioned in this article. However, occupational therapists are knowledgeable in child development, sensory processing, task analysis, and environmental modifications. All of these areas are areas that are important to consider when thinking about providing movements breaks throughout a child’s school day for increasing focus and learning potential of children. Occupational therapists need to advocate for their scope of practice and talk to the leaders in their education systems to advocate for movement breaks and provide education of the benefits of these breaks. The teachers would provide the movement breaks, and the occupational therapists’ job would be to provide tier one services to the classrooms and teachers.

Policy

The first policy implemented would be for occupational therapists to educate teachers on how to provide movement throughout the day while incorporating learning objectives for the class. Occupational therapists would also educate teachers on the basics of sensory processing, the occupation of play, and environmental modifications for increasing attention. First, occupational therapists in the school system would need to start to incorporate tier one services into the classroom. Tier one services are not implemented nearly as much as they should be, and this is a great way for occupational therapists to get to the entire classroom and the teacher in the most time effective way. Occupational therapists could educate the teacher to try to incorporate movement and multisensory learning into the different classroom subjects. For example, we could suggest that the teacher completes a relay race of completing math flashcards or toss a beach ball with questions on it for students to answer when it’s passed to them. Even standing at a white board to fix grammatical errors in a paragraph is still providing a chance to move for children. This is a great way to provide movement while still educating students.

While this is a great option, some teachers may not be willing to implement this approach of providing movement while teaching. Another policy could be to simply provide a list of small “brain breaks” every 20 minutes or so depending on the children’s age. Teachers with more traditional approaches may be willing to implement this break that only takes a small amount of time out of their class if they know how much it can assist with the child’s focus.

The final policy occupational therapists could implement would be alternative seating. Occupational therapists would educate the teachers and leader in education about the evidence behind alternative seating such as standing at the desk, beanbag chairs, rocking chairs, or foot fidgets. This would be a great way to provide movement throughout the child’s school day when still allowing the teacher to teach simultaneously.

Data

Data that would be required to implement these policies include:

·      The school’s budget in determination of no-tech vs. high-tech alternative seating

·      Classroom sizes

·      A survey on the perceptions of teachers in changing their classroom structure to provide movement breaks, movement teaching approaches, and alternative seating

·      Typical school schedule including classroom teacher changes throughout the day, class lengths, school schedule, etc.

·      Time when the occupational therapists could provide tier one services to the teacher and the classroom

·      Teacher perceptions of their students' attention in the classroom

·      Data on teacher’s teaching styles and which of these teachers already provide movement breaks

·      Amount of teachers and occupational therapists that would be willing to implement these policies

Implications

The policies mentioned above have a huge amount of implications for occupational therapy, especially in pediatrics and the school system. Implementation of these policies would increase awareness in the educational system on occupational therapy’s scope of practice and roles in pediatrics. Currently, teachers and leaders in the educational system may not know that occupational therapists have this extensive knowledge and can provide effective services in this area. These policies would also increase awareness of how occupational therapy services can be provided at the tier one level of RTI. Occupational therapy services on the tier one level can be so beneficial in not only providing wonderful services to the entire classroom, but also educating teachers in areas such as sensory processing, handwriting, and fine motor skills.

Cruz, D. D. (2017, March 21). Why Kids Shouldn’t Sit Still in Class. Retrieved April 08, 2017, from https://www.nytimes.com/2017/03/21/well/family/why-kids-shouldnt-sit-still-in-class.html?utm_source=huffingtonpost.com&utm_medium=referral&utm_campaign=pubexchange_article

Gorski, D. (n.d.). What is RTI? Retrieved April 08, 2017, from http://www.rtinetwork.org/learn/what/whatisrti

Educational Policy to Address Obesity in Adolescents: Starting Early

Issue

The New York Times posted an article on February 24, 2017, about the obesity epidemic in America and the radical idea of bariatric surgery for these adolescents. The number of adolescents ages 12 to 19 who are severely obese has nearly doubled from 1999 to 2014, going from 5.2 to 10.2 percent. More doctors and parents are faced with the idea of bariatric surgery being the only option provided to produce lasting weight loss in obese adolescents. However, this is a controversial topic. This article asks which is worse: accepting uncertainty about long-term health risks from surgery or the likelihood of serious health risks from remaining obese. Obesity causes serious health risks including type 2 diabetes, hypertension, sleep apnea, acid reflux, high cholesterol, and isolation and depression.  Obviously, something needs to be done about the issue but bariatric surgery may a radical and unnecessary option. https://www.nytimes.com/2017/02/24/health/obese-teenagers-bariatric-surgery.html?rref=collection%2Fsectioncollection%2Fhealth

Service Delivery

Play is an essential part of childhood, however, most children spend at least 4 to 5 hours per day in sedentary activity. Even though the issue presented is in adolescents, I think the way to prevent this issue from occurring is changing the mindsets of younger children. The habits developed as early as pre-k are often precursors to lifelong health patterns. I think that the best way to address this issue is through the educational system. This is the easiest way to get out to many children at once since they all attend school.  This is also where the child spends much of time of their day, most of it being sedentary. A collaboration of teachers, OTs, and school nurses could come together in attempts to change the issue of adolescent obesity. We also need to address the family dynamics, which is an area that OT could assist. Without addressing the family dynamics, we are not addressing what is fully accountable for the rise of childhood obesity.

Policy

I have multiple policy ideas that would address childhood obesity and health promotion in the educational system. This could be provided through multiple parts of the day. Before school begins, children could be encouraged to play. This could be through playing on the playground or you could also take the option of walking around the school building with a teacher that changes out every week. Throughout the school day, the occupational therapist could provide the teacher with quick movement breaks every 20-30 minutes. This would not only provide more movement throughout the day but also increase attention in classes. Alternative seating could also aid in decreasing obesity. Children could have the option to sit in bean bags, therapy balls or even at standing desks. Occupational therapists and school nurses could have a block in their weeks where they could go into the classroom and address health issues from obesity and fun ways to incorporate exercise during play and while at home. They could speak about long term lifestyle changes versus dieting. They could also educate students on making conscious decisions about the activities done every day. Occupational therapists could even set up activities to show how healthy eating or exercise can be made to be fun, such as growing a simple garden and taking turns making healthy menus and cooking healthy food. Occupational therapists could also provide after school sessions to parents that could assist in analyzing a family’s routine, suggest strategies to increase leisure and play at home, encourage parents and students to engage in sports and dance and reduce time in front of the TV, and find fun things to promote movement that the family can do as a whole. Finally, one of the most important parts of this policy would be to make it a requirement to incorporate recess into the students’ day. We need to promote the value of recess to school administrators. Afterschool programs that are non-competitive could also promote engagement for students with obesity that may be more self-conscious, such as yoga, walking, or dance. Addressing childhood health patterns and habits as well as family dynamics when the children are young, can influence the long-term risk of adolescent obesity before negative patterns are developed.

Data

• Data needed to support the policies mentioned above would include:
• Amount of students in each school district
• Amount of teachers, OTs and school nurses willing to implement these policies
• Time that school starts, classes per day, and class length
•  Sports that are currently provided at the schools
• Obesity rate in the schools
• When could a block of time be provided for the OT and school nurse per week to provide educational sessions
• Current family dynamics and health habits of children (although not necessary, as this kind of policy will still benefit all children, even if they already have health habits)

Implications

These policies would affect occupational therapy in the educational system in several ways. The policies would promote additional knowledge for other of the scope of practice for occupational therapy. In the education system, occupational therapy is often misunderstood for only working on handwriting, some sensory processing, and fine motor skills. However, occupational therapy can also work on the development of health habits to promote healthy occupational participation and performance throughout the lifetimes of children. Providing children with individualized, fun ways to incorporate gross motor play and healthy eating throughout the day is definitely within occupational therapy’s scope of practice. This policy could also be a great way to show the benefits of tier 1 occupational therapy services to administration and ultimately lead to other ways for occupational therapy to provide tier 1 services, such as classroom handwriting instruction or even a class about alternative seating to increase engagement and attention throughout the day.

Kolata, G. (2017, February 24). Doctors Consider a Last Best Hope for Obese Teenagers: Surgery. Retrieved March 05, 2017, from https://www.nytimes.com/2017/02/24/health/obese-teenagers-bariatric-surgery.html?rref=collection%2Fsectioncollection%2Fhealth

American Occupational Therapy Association. (2013). Addressing Childhood Obesity. Retrieved March 5, 2017, from https://www.aota.org/~/media/Corporate/Files/AboutOT/consumers/Youth/obesity.pdf 

Policy Blog #1: Policy Proposal for the United Way of Allegany County, MD

Issue

A news article posted on February 4, 2017, expressed that the United Way of Allegany County, Maryland is currently seeking ideas for programs and collaborations focused on poverty solutions. The largest community needs based on the community assessment given were "affordable before and after school care, innovative education initiatives, budget management, housing solutions, health and wellness programs, and transportation solutions". Here is a link to the news article: http://www.times-news.com/news/local_news/united-way-seeking-solutions-for-poverty/article_899dc0ac-621d-5ad1-817c-c86d865bdd34.html

Service Delivery

In my opinion, this issue should be addressed through a health service delivery system. Health professionals are highly skilled in working in these areas of concern listed above. My particular interest and proposed plan would begin by having occupational therapy and occupational therapy assistant students from nearby colleges provide service delivery. An occupational therapy assistant program exists at Allegany College of Maryland in Allegany County. This would be a great program to initiate this plan in the beginning phases. Occupational therapy professionals understand that poor health and poverty are related in part to restricted participation in a balance of meaningful occupations, or everyday activities. Occupational therapy students have the potential to target many of the issues determined through the community assessment. Occupational therapy students, ultimately, can work with individuals in any area that is impacting his/her ability to successfully participate in daily routines and activities. They are specifically trained in task analysis and adapting tasks and environments to help individuals become more successful.

In the long-term, if successful, this plan could expand to other local programs including psychology, education, social work, and nursing. Students in these disciplines would provide excellent and unique input to address the issues expressed by the United Way of Allegany County.

Policy

My proposal is as follows. The occupational therapy assistant program at Allegany College of Maryland will develop requirements for students to obtain at least 4 hours of community outreach per month through The United Way of Allegany County. Students can choose to volunteer through before or after school programs to develop knowledge about childhood development, encourage age-appropriate play and help the students develop appropriate coping strategies. Students could also choose to work with adults on goal setting, job interview skills, budgeting strategies, stress management, and education of community resources. Students could also volunteer to host free weekly sessions on health promotion topics such as healthy meal planning, preventative care, and exercise promotion. Another potential area for occupational therapy assistant students to volunteer in would be the development of innovative transportation solutions for those in poverty, such as a program that fixes used, donated bicycles.

Data

In order for these policies to come into action, data would need to be collected in the following areas:

·      Amount of students in occupational therapy assistant program at Allegany College of Maryland

·      Amount of students interested in each volunteer area

·      Amount of hours each student would like to volunteer per month

·      The hours that the students currently attend school

·      Logs would need to be kept that would demonstrate that students did participate in volunteering for this organization. The logs would need to be signed by an employee for United Ways of Allegany County.

·      Names and locations of schools that would need occupational therapy assistant students for before and after school care

·      Amount of students that would participate in all before and after school programs

·      Statistics of adults that students would be working with to improve relevancy of services provided (employed vs. unemployed, health status, areas of concern, etc.)

·      Facilities that would be willing to donate their space for students to volunteer (school lunch room, community center, YMCA, etc.); What hours and days would these facilities be able to donate this space?

·      Other non-profit organization in the area to collaborate with

Implications

This policy has the potential to impact many individuals’ lives for virtually no cost to the community or the United Way of Allegany County. Students from Allegany College of Maryland’s occupational therapy assistant program will gain valuable knowledge about emerging areas of occupational therapy and will be able to apply this knowledge to real-life experiences. Students will also have the option to choose which area they would like to volunteer in, making this initiative more enjoyable and applicable to the student and his/her interests. For occupational therapy as a profession, this policy has great potential to raise community awareness about the full scope of occupational therapy practice, as it is often overlooked and misunderstood. This initiative is a wonderful way to promote occupational therapy services and the potential that occupational therapy can have in many different areas that are currently underserved. In the long-term, this policy could also be applied to other programs at Allegany College of Maryland, increasing the benefits provided to both individuals in poverty in the community as well as current students in a variety of disciplines.

Marval, R., & Townsend, E. (n.d.). Homelessness: Enabling solutions in primary health-care occupational therapy. Retrieved from https://www.caot.ca/otnow/sept13/homelessness.pdf 

The Cumberland Times-News. (2017, February 04). United Way seeking solutions for poverty. Retrieved February 04, 2017, from http://www.times-news.com/news/local_news/united-way-seeking-solutions-for-poverty/article_899dc0ac-621d-5ad1-817c-c86d865bdd34.html