National Handwriting Day

Thanks to the folks at the Writing Instrument Manufacturers Association, tomorrow is “National Handwriting Day.” The date of January 23rd was chosen in honor of the birthday of John Hancock, whose name has become slang for a signature. Hancock was the first to sign the Declaration of Independence, and his large and distinctive handwriting has become among the most famous in our nation's history.

The keystrokes being entered to write this blog serve as a reminder, however, that handwriting is arguably less crucial a skill than it once was. Nevertheless, as we discussed in a prior blog post, some research suggests that handwriting may assist in the learning process in a way that typing cannot. There are also certainly situations in which handwriting is the only available means of written communication, or even a note-to-self. Handwriting clarity thus serves as an important tool for conveying information as well as for keeping organized. Students with graphomotor difficulties often face a unique array of challenges across academic areas.

Occupational therapists can help struggling students to strengthen the abilities underlying effective handwriting as well as to use assistive devices such as unique pencil grip products. We at The Yellin Center tend to recommend skill building in conjunction with bypass strategies, and so advise that work-arounds such as speech-to-text software should be considered as well, in appropriate contexts. Fluency in capturing and expressing information is important for optimizing the amount of material available for processing and the quality of ideas that can be generated. Therefore, it behooves students to use strategies that will help this fluency in the short-term while building the handwriting skills that will help them later.

          Happy Handwriting Day! 

April is Occupational Therapy Month

The American Occupational Therapy Association has designated April as Occupational Therapy Month. It's a good time to look at what occupational therapy -- often called "OT" -- is and how it can help students.

OT services are designed to support individuals with the tasks they encounter in their daily lives. For adults, this can mean helping them recover from an injury or overcome a disability to manage tasks at home or in the workplace. For students, OT supports such school-based activities as handwriting, keyboarding, and adapting the school environment to promote success. An occupational therapist can help connect students with both high-tech solutions, such as computers, software, and digital tools and low-tech aids, such as writing implements with special grips and notebook paper with textured lines. Services are provided by a licensed occupational therapist, who has trained in a master's level program and passed a licensing exam.

OT is a "related service" available to students with disabilities under the Individuals with Disabilities Education Act (IDEA) or Section 504, provided by the school during the school day, without cost to the family. It can be a "pull out" service, where the student leaves the classroom for a period to work with the occupational therapist, usually in a small group but sometimes individually. Or it can be a "push in" service, where the therapist comes into the classroom and works with the student or students as they go about their daily activities. This is a particularly effective way of providing services, since research demonstrates that skills are better mastered when they are practiced in the environment in which they occur. The frequency and duration of these sessions need to be specified in the IEP or 504 Plan. Some families choose to work with an occupational therapist who has a private practice outside of a school.

In addition to helping students with graphomotor (handwriting) difficulties and keyboarding skills, an occupational therapist can help address such issues as the need for specialized seating in the classroom or on the bus, learning self-care (for students with significant disabilities), and practical matters such as managing a backpack or dealing with sensory issues such as intolerance for excessive noise or school bells and buzzers.

Related Services

Both the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act of 1973 (Section 504), the two federal laws that families rely upon when their children need help in school because of learning or other disabilities, mandate that children be provided with "special education and related services." We've written before about both of these laws and how they work, but our focus here is on the related services that both laws require schools to provide for students.


What are related services? The IDEA defines such services as:

"...transportation, and such developmental, corrective, and other supportive services (including speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, social work services, school nurse services designed to enable a child with a disability to receive a free appropriate public education as described in the individualized education program of the child, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services, except that such medical services shall be for diagnostic and evaluation purposes only) as may be required to assist a child with a disability to benefit from special education, and includes the early identification and assessment of disabling conditions in children.

The IDEA specifically notes that related services do not  include a medical device that is surgically implanted, or the replacement of such device. These devices can include a cochlear implant for students with hearing loss or an insulin pump for students with diabetes. Section 504 refers to "related services" without such an extensive definition, but districts generally apply the same definitions as they do to IDEA services.

Let's look at each of these services and see how they might apply to your child.

Transportation above and beyond regular bus service provided for all children may include bus service to and from school in a regular bus, or service in a bus with a bus aide, or transportation to school related activities. For students who have been placed by their district or parents in private special education schools, this can include transportation beyond the distances generally allowable to other students. Note that special transportation services must be specifically provided for in a student's IEP or 504 Plan; such service is not automatic.

Speech-language services include a wide variety of services provided by a licensed speech and language pathologist. These services are generally provided in small groups, but can be individual. They go beyond correcting difficulties with articulation and can be very helpful to students with expressive language problems of all kinds. Note that the IEP or 504 Plan needs to specify the frequency and duration of such services and the student-therapist ratio. In an IEP this can look like: "Student will be provided with speech-language services three periods of 45 minutes per week in 5:1 setting (ie: one speech therapist working with a group of five students)." Usually, the smaller the group, the more intensive the services provided.

Audiology, interpreting, and orientation and mobility services are provided to students with hearing and/or vision difficulties or blindness.

Occupational therapy is often provided to students with graphomotor (handwriting) issues and can assist these students with both handwriting and keyboarding.

Physical therapy helps students with mobility, balance, and movement difficulties manage their movements around the school. Note that these services, as well as the other services discussed, all must be specified in the IEP or 504 Plan as to frequency, ratio, and duration.

Other related services that can be included in an IEP or 504 Plan can include counseling, social work, and psychological services, all of which can be provided to any student who needs them. Medical services can also be provided, but are limited to diagnostic services. This distinction between educational and medical services is consistent with the focus of the IDEA on providing only those services which help as student to obtain a benefit from his or her education.