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Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS, OTR/L, FAOTA VOTA School System Symposium March 5, 2016

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Page 1: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaborating for Change:

Starting and Sustaining

System Supports

Barbara Hanft, MA, OTR/L FAOTA

Jayne Shepherd, MS, OTR/L, FAOTA

VOTA School System Symposium

March 5, 2016

Page 2: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Objectives

• Define collaboration partnerships and roles for

OT in schools.

• Select strategies for promoting opportunities

for collaborative system supports;

• Identify how to engage team members at

various stages of a change process;

• Apply the elements in change models to initiate

and sustain system supports.

Page 3: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaboration in schools…

…. interactive team process that focuses

student, family, education, and related

services partners on enhancing the

academic achievement and functional

performance of all students in education

lessons and school activities.

Hanft & Shepherd, Collaborating for Student Success (2nd ed)

Page 4: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Partnership Continuum…

Cooperation

Coordination

Collaboration

Page 5: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Partnership Continuum… Cooperation

Cooperation

Coordination

Collaboration

Interaction: Informal as needed

Leadership: Unilateral

Resources: Separate

Planning: No joint effort

Goals: Separate

Page 6: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Partnership Continuum… Coordination

Cooperation

Coordination

Collaboration

Interaction: Communication

channels for info

Leadership: Some shared

Resources: Available for specific

projects

Planning: Task/project specific

Goals: Reviewed for

compatibility

Page 7: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Partnership Continuum… Collaboration

Cooperation

Coordination

Collaboration

Interaction: Division of labor

Leadership: Dispersed and shared

Resources: Pooled and shared

Planning: Comprehensive

Goals: Common

goals/mission with

joint accountability

Page 8: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Consider your

school team(s)….

Where do they function on the

partnership continuum?

Page 9: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaboration includes…..

Coaching

Co-teaching

Collaborative consultation

Collaborative interaction

Collaborative teaming

Integrated therapy

Transdisciplinary teams

Page 10: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaboration is NOT …

• Equating conversation with collaboration and

caring with teaming

• Getting together at a meeting; talking with one

another

• Any type of discussion about a student, formal

of informal

Page 11: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Characteristics...collaborative partnerships

• Equality and respect

• Shared purpose and commitment

• Collective decision making

• Shared resources and knowledge

• Joint responsibility for outcomes

Shepherd & Hanft, in press

Page 12: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaborative Roles for OT

Team Supports

“on behalf of a child”

Hands-on with Team Supports

System Supports

Page 13: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Hands-on with Team Supports…

Promote academic achievement & functional

performance of individuals/groups

Example: HS student with CP

Hands on…

Assess: AT needs

Adapt: Classroom materials

for science/lab

...with team supports

Consult with: gen/sped

teachers to identify test

accommodations & system

for progress monitoring

Page 14: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Team supports on behalf of a child

1. ↑ performance of specific students

– Co-teaching

– Design/adapt classroom spaces & learning centers

– Assess effectiveness of a specific intervention

2. ↑ knowledge/skills re: student skills/team tasks

– Mentor new colleagues re: assessment & IEPs

– Coach team members to implement EBP

– Share research and present intervention

Page 15: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

System Supports

Formal/informal initiatives & programs

that address the education needs

of a grade, school building or population of

students within a district, county or state.

Page 16: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

System Supports

1. District-wide student assessment/instruction

– Response to intervention team (RtI)

– Specialized programs

• Positive Behavioral Intervention Supports (PBIS)

• Transition to work; Assistive Technology

– Special populations

• ASD; low-incidence disability

Page 17: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

System Supports…

2. School policies, procedures and initiatives

– Task forces/committees

• (curriculum, UDL, assessment accommodations)

– Implement district wide programs

• (bullying, PBS)

– Develop guidelines for state/local OT

services

Page 18: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

System Supports….

3. Education/professional development

– PD for educators and related services

• EBP for OT for Autism Spectrum Disorder

– OT mentoring program

– Presentations and liaisons to PTA, community

groups, health agencies

Page 19: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

System Supports in Action

Every Moment Counts

(Susan Bazyk PhD, OTR/L, FAOTA)

http://www.everymomentcounts.org/

Consider: How OT’s use knowledge/skills

Discuss: Identify collaborative characteristics

Page 20: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Key Elements:

Initiating System Supports

Educate stakeholders and solicit support (Rogers, 2000)

• What to say, and when, to education partners i.e.,

families, administrators, education personnel

Direct the rider*

• Big picture and vision

Motivate the elephant*

• Manage change & build knowledge/skills

Shape the path*

• Identify resources, challenges and action steps

*Heath & Heath, 2011

Page 21: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Direct the

Rider

(Rational)

Follow Bright Spots:

What's working?

Script Critical Moves:

Big picture

Point to Destination:

Vision

Motivate

the Elephant

(Emotional)

Find the Feeling:

Motivation

Shrink the Change: Manage change

Grow your People:

Knowledge Identity

Shape

the Path

(Situation)

Tweak the Environment

Analyze trends

Build Habits: Action steps

Rally Herd: Assess

progress

Switch (Heath & Heath, 2011)

Heath, C., & Heath, D. (2011). Switch: How to change things when change is hard.

New York: Broadway Books.

Video Review for Switch from Callibrain. https://youtu.be/qmmwWxVzSsw

Page 22: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Consider How to Solicit Support(Rogers, 2000)

1. Relative Advantage: “Show me the benefits.”

2. Complexity: “Give it to me real simple.”

3. Compatibility: “Help me see how it relates to

what I know and believe.”

4. Observability: “I want a look-see.”

5. Trialability: “How about a test drive first?”

Page 23: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Case study: Shifting to an integrated

model of OT services and supports

Issue: Related services provided via pull-out model due to:

1) Limited knowledge of school staff re: integrated therapy;

2) Belief of staff/parents that pull-out is most effective;

3) Lack of time to devote to changing practice.

Conway, in Hanft, Swinth & Shepherd, in press

Page 24: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Direct the Rider

Point to the destination: Shift therapy

services and supports to an integrated model.

Script critical moves:

1. Buy-in from admin for 2 hr. orientation with OT consultant:

– IDEA mandate

– evidence supporting integrated services &

benefits (Relative advantage)

– discuss what’s working (Follow bright

spots)

Page 25: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Direct the Rider con’t

Script critical moves:

2. Conduct time study analysis of OT/PT

Results:

Pull-out: 75%

Integrated: 25%

Page 26: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Motivate the Elephant

Find the feeling:

Talk with therapists and teachers to motivate them

to help develop a plan (Complexity)

Shrink the change:

Find supportive partners to pilot “mini trials” of

integrated services (Trialability)

Page 27: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Motivate the Elephant con’t

Grow your people: Initiate a CoP with all stakeholders:

– Principals

– Gen ed/sped teachers and paraprofessionals

– School psychology or guidance counselors

– Parents, parent mentor

– OT, PT, & SLP (Bazyk et al, 2015)

Key concern addressed: Integrated therapy

perceived as inferior to pull out (Compatibility)

Page 28: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Shape the Path (9/12-6/13)

Build habits: Goal: 25% → 40% integrated OT/PT

Staff/parent preference for pullout overcome with-

Admin support = planning time

Collaborate 1st w/ receptive teachers = new skills

Embed services/supports in RtI model = OT/PT

welcomed in classrooms, art, music, PE

Page 29: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Shape the Path (9/12- 6/13)

Rally the herd: Assess factors → success

Shared leadership + collaborative partnerships among

stakeholders

Therapists ability to reflect on practice & consider change

Administrative buy in and support from beginning

CoP fosters collective learning and new practice

Build on existing relationships with receptive education

team members

Page 30: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Date Pull-out

therapy

Integrated OT/PT (gen

ed, resource room, other)

2/2012 75.5% 24.5%

6/2013 40.0% 60.2%

6/2014 29.7% 70.3%

Conway, in Hanft & Shepherd, in press

Rally the Herd: Survey results

Page 31: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Collaborative Partners…

Implementing partners

Promoting partners

Guiding

partners

Carry out the action steps identified

by a planning group

Supervise, administer regulations, set

standards and control resources.

Offer info, support, and positive

public relations

Page 32: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Back to future….

Revisit: Where does your team(s) fall on the

partnership continuum…

1.What collaborative elements would enhance OT

system supports to promote student learning?

2.Whose support is crucial in making a system

change?

Page 33: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

References

Bazyk, S. Every Moment Counts. Ohio Department of

Education, Office of Exceptional Children.

www.everymomentcounts.org

Bazyk et al. (2015). Building capacity of occupational

therapy practitioners to address the mental health needs of

children and youth: Mixed methods study of knowledge

translation. AJOT, 69 (6), 1-12.

Hall, G., & Hord, S. (2006). Implementing change:

Patterns, principles, and potholes (2nd ed.). Boston:

Pearson Education.

Hanft, B. & Shepherd, J. (in press). Collaborating for

student success (2nd ed). Bethesda, MD: AOTA.

Page 34: Collaborating for Change: Starting and Sustaining System ... · Collaborating for Change: Starting and Sustaining System Supports Barbara Hanft, MA, OTR/L FAOTA Jayne Shepherd, MS,

Hanft, Swinth & Shepherd. (in press). Initiating &

sustaining system supports (Ch 8). In Hanft & Shepherd,

Collaborating for student success (2nd ed). Bethesda, MD:

AOTA.

Heath, C., & Heath, D. (2011). Switch: How to change

things when change is hard. New York: Broadway Books.

Mattesich, P. (2012). Cooperation, coordination and

collaboration table.

https://www.conservationgateway.org/Files/Pages/cooperati

on-coordination-.aspx#sthash.J9gTMRFz.dpuf

Rogers, E. (2000). Diffusion of innovation (5th ed.). NY:

Free Press.