How I’m Making My School-Based OT Practice More Equitable

Black lives matter. They always have, but it’s become more and more apparent the abhorrent and systemic injustice that the BIPOC community experiences on a daily basis. And while there is certainly work that needs to be done at the national level, the really insidious and sneaky racism happens quietly in your own community. For that reason, I’m taking a look at my own work to determine how I can be actively anti-racist as a school-based therapist. It’s incredibly important to me to provide equitable school-based OT. Some of these actions are things I’ve always done but will be reviewing more closely, and some are new to me. I think this work is especially relevant to school-based practice because, like many systems in this country, our schools were not designed to benefit BIPOC students. I hope these action items are helpful to consider, and if you have any suggestions for what I could be doing better, I would love to discuss it further in my group here

Auditing my School-Based OT Services 

How do you determine when a student needs school-based OT? This is one that I’ve tried to be aware of since working in a district where 95% of my students were first- or second-generation Hispanic immigrants. By and large, Caucasian families in this district were more well-connected, knew more about their special education rights, and were more effectively able to advocate for their students. On the contrary, many of my Spanish-speaking families seemed to just be grateful to be receiving special education services at all, and didn’t tend to question our recommendations or advocate for more time. 

This one is tricky as a school-based OT because even if you make recommendations that are pretty similar across students of different races, the IEP team doesn’t necessarily have to agree and approve your services. I’ve definitely had the experience of recommending less service time to well-connected white families who end up bringing in advocates, lawyers, or just refusing to sign the IEP to avoid the decrease in services. 

If you’d like to take a look at this too, I’d suggest making a list of your students and writing down all of their service times. Are your students with similar needs receiving similar levels of service? If not, what can you do to bridge that gap?

Using Inclusive Therapy Materials 

Something I’ve realized this year is that there is a true dearth of age-appropriate resources for older students with disabilities! It’s really tricky to find materials that do not have cutesy pictures, goofy fonts, or just inappropriate language. And finding materials that are age-appropriate AND depict students of color? Pretty much impossible.

For that reason, I’ve taken to making a lot of my own handouts. One, in particular, I made this year was a parent education sheet on how to teach your child how to complete hairbrushing/grooming tasks. I realized that the strategies I thought of by default really only applied to people with long, straight hair. I took some time to educate myself on Black haircare and made sure to include that as a main part of my handout – not as an afterthought. I’m embarrassed to admit that I don’t know if I would have thought to include this a few years ago. 

If you want to do this too, take a close look at your therapy session go-tos. Do they depict students from a variety of backgrounds? Are BIPOC children presented in a subtly negative light (for example, are the Black characters in your therapy worksheets depicted as being in trouble/in the wrong more often than white characters?) Do your home program strategies for ADLs target people from Caucasian backgrounds by default? 

If you’re having trouble finding materials that are culturally inclusive, you can always consider making them on your own. If you feel that you don’t have the time to do that, consider paying someone from the BIPOC community to make these materials for you – the financial cost is small compared to the difference it will make for your students. 

Developing RtI Programs for Equitable Access to OT

Our special education system is far from perfect. In the best of times, it helps struggling students demonstrate real growth. But in the worst of times, it can be used as a method of segregation for BIPOC children. Did you know that Black children are more likely to receive special education services than white children? While on its face it might sound like this is helpful, in reality, Black children are often misdiagnosed with emotional and behavioral disorders that send them to self-contained classrooms. This isn’t doing our students justice.

Systemic change needs to happen in this area, but in the interest of focusing on what I can control, I plan on developing more programs under the Response to Intervention framework this year. I have always loved working under this model, but I think it’s especially prescient now. Early intervening services to at-risk students can help keep kids in their general education classrooms for longer. Some children who progress through these programs end up not needing special education services at all. And this is also a great way to keep an eye on children who really DO need special education but might not have a family that knows that they can advocate for this.

My biggest barrier to implementing this is that I’m not sure what school will look like when we return in the fall – I don’t think anyone will. But even if I have to run groups or training via video chat, I am committed to trying to reach more students with these interventions. 

Speaking up When I See or Hear Things That are Wrong

Gosh, this one is probably the hardest. And that also means that it might be the most important. Anyone who knows me knows that I’m already pretty vocal when faced with injustice, but this is still one where I feel like I struggle. It’s really easy to speak up against overt racism like someone calling a child the n-word, but that’s not how most racism presents itself. It’s subtle. It’s people speaking negatively about how a family has no carryover of strategies at home – but only speaking that way about BIPOC families. It’s taking advantage of English language learner parents who don’t realize that an administrator is legally required to be at IEP meetings – but making sure there’s always one there for white families. It’s the little daily microaggressions of watching your only Black coworker have her hair touched without permission.

We can’t keep letting these things fly. As a white person, I need to recognize my privilege and speak up every time I see injustice, even when it makes me feel awkward and deeply uncomfortable. 

Making Sure Students Have Equitable Access to Technology

This one became super apparent this year when we all had to quickly switch to distance learning. I’m pretty impressed with my current district’s response -they provided all students with a Chromebook and hotspot if they requested them – but there’s always room to grow. I’m definitely going to make sure that if I will be doing teletherapy again in the fall that all of my students will have equal access to the needed technology, with interpreters provided if need be. Another thing I need to keep an eye on regardless is making sure students have appropriate technology to engage in written or verbal communication. Too often, we introduce this technology way later than it should be. It’s important to remember that assistive technology must be provided if the student cannot fully access their education without it. 

It’s really easy to fall into feeling sad and stressed about the current state of the world. But it’s important to realize that BIPOC people have probably been feeling that way for much longer than you have. They need you to fight for them. They need you to fight for their kids. And that fight doesn’t begin on the floor of the Senate – it begins right here at home. I’m hopeful these strategies were helpful to you to consider how to become a more equitable school-based OT. And I would love feedback on what I could be doing better – because I don’t always get it right either. To join the conversation, come find our discussion in my Facebook group here

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