7 Reasons Why School-Based OTs Should Push In

School-based OTs should push in to the classroom! What does this actually mean? Put simply, pushing in means you are delivering your OT service in the student’s classroom or other natural environments such as the playground, cafeteria, or gym. Instead of pulling a student to a separate room to do a pre-planned activity, you’re supporting the natural occupations that a student encounters during the school day. Providing this type of contextually relevant service is the heart of OT, but if you’re not yet convinced, here are 7 reasons to start moving your practice in this direction. 

1. It Upholds The Natural Environment 

What more natural environment is there for a student than the classroom? This is likely where your student spends 90% of their school day, and is the place where they’ll engage in all of those good occupations like writing, reading, organizing their work, completing tabletop activities, listening to instruction, etc. Providing therapy in this environment means what you’re doing is both realistic and relevant to the student’s day. Plus, it makes it way easier for your students to generalize skills. Considering the environment is one of the biggest parts of being an OT, and your student’s classroom is an environment that they spend much more time in than your therapy room.

2. It Saves Time

If you feel like you spend your whole day running around the building hunting kids down, pushing in can save some transition time! This way, you’re not doing the extra steps of walking to the classroom, picking up a kid, walking to a different location, doing therapy, then walking back to the classroom. Instead, you can start your work the moment you arrive at the classroom – and be ready to see your next student as soon as you’re done.

school-based OTs push in classroom

3. It Helps You Become Familiar with Grade-Level Expectations

As OTs, we don’t get training in academics the way teachers do in their preparation programs. As such, becoming familiar with different grade-level expectations can be a bit of a learning curve, but one that is so important to master. If you don’t know what the expectations are in the classroom, how can you be sure the therapeutic activities you choose are supporting your student? Beyond academic expectations, you’ll also get insight into other classroom norms, like how long students can attend to classroom instruction, how often students are required to copy from the board, and how independent students are with organizing their classroom materials. Your student may not be meeting these norms yet, but knowing what they are allows you to work in that direction. 

4. It Keeps Your Interventions Meaningful

Look, Pinterest-worthy craft activities can be great. But they’re not necessarily the best way to work on skills, and sometimes they aren’t even relevant to the student’s needs at all. Pulling a student once a week to work on a generic fine motor craft ultimately has so little impact without the knowledge of what the student is actually required to do in the classroom. Too often, this type of intervention is well-intentioned but not relevant to what the student does in class, and thus does not help them engage more successfully in the occupation of being student. When we push in, the tasks we work on are directly related to the student’s educational work and not just a contrived activity. 

5. It Makes You Notice All the Factors That Go Into a Task

How many times have you had a student produce beautiful handwriting in your session, be on the verge of discharging them, and then find classroom work samples that are illegible? Doing a complex task like writing sentences in a quiet room, with plenty of time and 1:1 attention is a much different task than your student’s writing time in class. They have to be organized enough to find their pencil and paper. They have to be able to filter out the distractions and noise of the classroom. They may have to sit next to a peer that drives them nuts. They may have to fit their work into tiny, unlined boxes on a worksheet instead of the nice 3-lined paper you’ve been providing in your sessions. They have to be able to work under pressure with limited time. And they have to pay attention to the academic components of the work too, in a way that likely requires much more focus than the more leisurely writing activities you plan for a pull-out session. Actually seeing what your student is doing in the classroom allows you to turn on that activity analysis and use your OT brain to remove barriers. 

school-based OTs push in classroom

6. It Allows Others To Learn From You

When you push in to the classroom, your student isn’t the only one paying attention to you. Teachers, paras, and other students are also there observing you support your student. And while this may feel intimidating at first, it’s a great opportunity for those other players to learn what strategies you’re using so that they can help implement them when you’re not there. As OTs, sometimes the strategies we use seem so simple and commonplace to us, but can be mind-blowing for a teacher or para who simply don’t have the same education and experience as we do. Allowing them to see the strategies you’re using (and hopefully seeing them working!) is a great way to provide education to school staff that doesn’t feel pushy or commanding. And don’t write other students off, either – I’ve had so many peers step in to help remind my student to use a tool or a strategy that I’d shared with them!

7. It Builds Relationships 

Becoming a regular fixture in a classroom is the number one way I’ve built relationships with both adults and students. It allows you to get to know teachers and paras in a way that you wouldn’t be able to if you only saw them in passing as you pulled your student from their class. Being an actual support in the classroom is a skill, and does take some practice to get right without feeling like a burden on the teacher. But it is absolutely a skill that is so valuable and worth devoting time to. This makes it so much easier to become part of the fabric of a school and not just the “OT lady” who works her magic in a room where no one else sees. And gosh, it is so nice to build those relationships with other students, too! Being able to jump in and support all types of students, even those who aren’t currently receiving my services, makes me feel so much more of a true support than someone who just comes in, sees her caseload, and leaves. 

Education happens in the classroom, and if education is what we’re supporting, that’s where we should be. While it can be challenging to shift your practice if you’re used to providing pull-out services, this is such a worthy goal to ascribe to. If you’re wondering how to actually make this transformation in your work, I’d love to have you in my signature course, The Dynamic School OT. It goes beyond theory and teaches you actual, actionable strategies for providing meaningful, evidence-based OT services in the classroom. I can’t wait for you to have a school-based OT push-in practice that you love!

7 thoughts on “7 Reasons Why School-Based OTs Should Push In”

  1. So you are saying join the lesson and support the student during that lesson? What if the teacher is lecturing? What if the lesson does not work on the OT goal?
    Thank you!

    1. Yes! For scheduling purposes, I always try to come in at a time when I know students will be working and not just listening to a lecture (unless I’m supporting attention and note-taking).

  2. Pingback: 8 Myths About Push-In OT - Devon Breithart

  3. Rebecca Schmidt

    That sounds WONDERFUL if your caseload allows for it. If your caseload is like many of us where we get students from 2 or more classrooms and see them at the same time so that we can fit everyone in our schedule, then it is impossible.

    1. Scheduling is definitely the biggest barrier! However, something important to keep in mind is that we should never be grouping students unless the quality of service they receive is equal or greater to the service they would receive in an individual session. If your caseload is so large that you must group students to simply fulfill all of your service minutes, it’s time to have a conversation with admin about a more reasonable workload. Easier said than done, of course, but something very worthy of advocacy!

  4. You’ve raised a great topic, Devon, especially during Covid when relationship renewal will be front and center in the coming year. You inspired me to take another look at how I can make more push in happen for my students. Our district is moving toward a more inclusive model so this might be the ideal time take a fresh look at service delivery models. Thanks, Devon!

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