Co-Treatment with an OT: Part 1
In my last post, I started a discussion about alternate service delivery
models than traditional small-group or 1:1 pull-out for speech-language
The first of these I'm going to discuss is co-treating with the
At my elementary school, I work in a primary Life Skills classroom.
These students all have cognitive impairments, speech-language impairments, and motor difficulties due to varying diagnoses.
These students are probably the busiest kids in the building! Within a course of a week
depending on need, students could have up to 60
minutes of pull-out speech therapy (plus additional push-in time which
I'll discuss in another blog), 30-60 minutes of OT, 30-60 minutes of PT,
vision therapy, and/or up to 60 minutes of
music therapy. Many of these therapies are provided as 1:1 pull-out.
In addition to the therapies, the students also attend lunch,
recess, and specials with their grade-level, regular education peers.
Oh, and now and then they are supposed to get some sort of academic and life skills instruction to meet their IEP goals.
The OT who works with the primary life skills classroom works only part-time and is only there on certain days of the week.
The PT is only there on one day a week, as is the case with music
and vision. Needless to say, since I'm on a six-day cycle (and
therefore don't see the kids on a days-of-the-week basis), fitting these
kids in for speech instruction can involve a ridiculous
amount of juggling. If I have an IEP meeting and need to miss a student
to make up at a later time, forget it!
The OT and I were finding that often times we were scheduled to
see kids at the same time are consecutively (meaning they'd be out of
their classrooms for an hour chunk of time).
After some discussion and problem solving, we decided at least for some cases, co-treatment
with the students would best meet their needs.
had asked the OT previously about how each of the students communicated
with her (as many are unintelligible, minimally verbal, or non-verbal).
When I found out that sometimes the answer
was "not at all" I knew that I needed to get these students to work on
using their communication skills with her.
The OT and I tried to co-treat at least once per month for a handful of our students.
It was very successful for students using AAC, whether it was a
no-tech board/book, a low-tech device, or while trialing a high-tech
At first, the OT and I met prior to sessions so I could find out
what her targeted objectives and activities were for the students.
However, after awhile, we just planned our sessions via email. That's
the great thing about communication — no matter
what she was working on with the students, it was easy for me to embed
the students' speech-language targets within the sessions. We found it
didn't work well for all students for various reasons. As with all
therapy, some trial-and-error is necessary, and
you need to know your students to know what works best.
Co-treating with the OT for primary life skills students is something I plan on continuing next year.
We've already mentioned it to the parent of one of our incoming kindergarteners, and she was completely in favor of it.
Just from my experience last school year, I found it served two great purposes:
- The OT had the opportunity to see what the students were
capable of doing and how to get the students to use their communication
systems when working with her, and;
- The students had the opportunity
to practice carryover/generalization of skills
to a different environment.
you are looking for a way to fit over-scheduled kids into your therapy
schedule, consider co-treating with your OT. I've also done co-treatment
in a different way with my
middle school autism support students that I'll discuss in an upcoming blog.