Collaboration In Kindergarten Enhancing The First School Experience

Editor's note: This text-based course is a transcript of the webinar, Collaboration In Kindergarten Screening: Enhancing The First School Experience, presented by Tere Bowen-Irish, OTR/L.

*Please also use the handout with this text course to supplement the material.

Learning Outcomes

• After this course, participants will be able to differentiate at least 3 therapy-related contributions to the screening process.
• After this course, participants will be able to analyze specific parts of the screening tool that will provide information on each individual.
• After this course, participants will be able to differentiate between those screened who may need further observation, evaluation, or intervention.

Introduction

Hello everyone. It's a pleasure to be with you today. Before we begin, I would like to share my disclosures, discuss the limitations and risks associated with this topic, and outline our learning objectives. By the end of our time together, you'll be able to differentiate at least three therapy-related contributions to the screening process. You'll also be able to analyze specific parts of the screening tool that provide information for each student and distinguish between those who may need further observation, evaluation, or intervention.

Let's begin by considering what we might witness if we were part of a screening process. I encourage you to take a moment to jot down some ideas. This is a common practice for us as we often do this when we're given an evaluation to complete.

What Are We Looking For?

When a typical kindergartener walks in, what are we looking for? What would you be curious about in your role within the context of school therapy? We have our own unique lens as therapists, regardless of the group we're working with. We need to see our own perspective, but also to view the world through the eyes of others. When we communicate as a group, we can better recognize a child's abilities and challenges.

We're examining aspects such as fine motor skills and how they utilize their hands in a lead-assist pattern. Are there articulation issues? What does their postural control look like? Do they have pragmatic language ability? Are they understanding directions and positional words? What about motor control, planning, and so on? I won't read everything to you, but this is a sample of what we're looking for. By observing both the positive and negative, it helps us all validate what we're truly after.

Domains of Kindergarten Readiness

When examining the domains of kindergarten readiness, there are five of them. The first is language and literacy, where they assess receptive, expressive, cognitive, and math skills. This has to do with problem-solving, cause and effect, numbers, measurement, and positional language. Another domain is physical health and motor skills. This is a regular education initiative, so you can see how much we already have in common with them. This enables us to seamlessly participate in these screening processes, hopefully warding off future evaluations and contributing to a group that identifies what kids may need a little extra support. Social and emotional readiness is a large part of it. And finally, what are the child's approaches to learning? This is similar to their temperament and style. Are they curious? Do they like trying new things? What do you notice about their engagement and persistence?

When you have several people looking at a child for 10 to 15 minutes each, and you get together to discuss what you saw, you may see very similar observations or very different ones. Oftentimes, when I do it, I'm the "fun lady" because I have toys and balls, whereas those who have the children sit and answer questions may not be able to do it. When we consider the domains we want to examine, insight into the skills expected to enter kindergarten helps us. When we better understand the parts of the curriculum, it allows us to determine who is going to be challenged. The collection of data for the screens is crucial, as I mentioned, for the comparison of what you all found.

It is fascinating. Historically, if I have a child draw a person and the special education teacher does the same, we compare and contrast their drawings. How many prompts did she or I give? What did that lean up against? With "Simon Says," were they just not really understanding where they were in space? When we examine those general observations, we note what happens when they come to the door: Do they separate from their parent? Is there eye contact? Do they appear to understand directions? Are they hesitant, restless, tearful, or scared?

Variation in Ages Based on Birthdate and School Cut Off

When we look at this as a group, we gain a better understanding of what we might see come August or September, when school starts. Another interesting observation that has always amazed me is that the cutoff date for certain states or schools can vary dramatically. Where I live now, in New Hampshire, September 1st is the cutoff. And so, you could have a 4.11-year-old in your class who has just turned 5, and you could have someone who had to wait a year because they were born in mid-September, and they're 5.11.

When we examine this, we are all familiar with child development, motor skill development, and language development. We may also be able to notice that we initially think these children are lagging, but when we check their birth dates, they're just young. So, if your school offers a multi-tiered system of support or RTI, those children may benefit more and get a kind of preventative ancillary service from school-based therapists in all realms.

Brigance Assessment

The teacher may be administering a test called the Brigance, and it's interesting to see the commonalities we have in what we're examining. They're becoming more specific in their understanding of whether they know their letters, but they're also evaluating visual discrimination and gross motor skills. We all complement and support one another. It's essential, and I'll discuss this in an upcoming slide, that we examine whether we are being redundant and what's important about that redundancy. Are we going to see different things, or should just one of us be making that screening?

Speech and Language Therapy Screening

I spoke with a speech and language pathologist I've worked with for many years, and I asked her about her main priorities when doing a screen. She said there are some great tests available, but you have to be aware of the time limitation, and I feel the same way as an occupational therapy practitioner. The primary things they look for are articulation, naming pictures, the child's expressive language, receptive pragmatic language, phonemic awareness, sequencing, and their understanding of how something works. She suggested some links for those who are interested. If you design a screening cohort, you could share this with your speech-language pathologists and physical therapists. I also spoke with a physical therapist I've worked with for years. She looks at things that are often very similar to what I look at, just in a slightly different way. She suggested resources for pediatric kindergarten screening. We have to understand that it would be great if we had all three services available all the time. Some schools do have that, but if someone is missing, we can still provide information after the screening is done.

Physical Therapy Screening

Not all schools have a full-time physical therapist on staff at all times. So, if I notice anything dramatic that is out of my wheelhouse or certainly not in my lane, that's when a flag will go up. We're going to discuss the flagging system for when we require additional information about a child.

Occupational Therapy Screening

I have added two samples of occupational therapy screenings to your handouts, along with links for speech-language pathologist and physical therapist screenings. The other thing I have included in your handouts is materials for parents and teachers. Imagine a child showing up for a screening. Their parents are going to be waiting for up to an hour. If a speech and language pathologist sees the child for 15 minutes, I see them for 15 minutes, and then the special education or regular education teacher and possibly a physical therapist also screen them, that whole process takes about an hour. In my experience, we've provided things for kids to take home so the parents can read them over and over again. This includes ideas for exercises and things to do in the summer. You'll see a calendar that I used to create, which features developmentally appropriate activities for parents to post on the refrigerator. I've also included various ideas for toys and visual integration activities that can be done.

Over the years, we also added a sensory screen. It's not perfect, but it will at least start the conversation if parents are noticing issues with their child's sensory processing and are concerned about it. We view children as either green-flag, yellow-flag, or red-flag. The reason we did that is because a green-flag child has passed within the norms for what we were all screening for. A yellow-flag child may have mild to moderate challenges that we are not yet entirely sure about, and they may require further investigation. A red-flag child needs to be looked at again immediately, so maybe an evaluation needs to be started right away. Typically, teachers will want to conduct these screenings in March, April, or May, as this is when they're setting up their classes. Once they know what's going on with the incoming kids, they can set up the groupings and understand if they're going to need an aide or what other equipment might be necessary. It also gives them a chance to get to know the parents and encourage that communication.

As you will see, in my own screening, I try to set the stage to see as much as I can. I usually use a modified version of the Slauson drawing coordination test, which is an oldie but a goodie. I only use the first page because it is relevant to children up to about age five. What I like about it is that it has a child make a series of marks. You can test a child from age one all the way to adulthood, honestly. The first page has them do a scribble, a vertical line, a circular scribble, a square, and a regular circle. Triangles aren't something we should worry about so much for diagonal development until children are about six, but obviously I have had kids who were able to do them. I look at their pencil grip and how they use their hands in a lead-assist pattern. I'm a real proponent of eye dominance, which comes before hand dominance, and an average three to three-and-a-half-year-old will develop an eye dominance. This doesn't mean they see better with that eye or that it is more acute; it's just their aiming eye. What I often notice when I'm dealing with kids who may have hand dominance challenges is I look at what the eye dominance is to see whether or not they are choosing the same side, which most of us do. If you're left-eyed, you're usually left-handed. However, about 20% of the population has cross-dominance, meaning they might be left-eyed and right-handed, and 5% are left-handed and right-eyed. Functionally, when I'm watching a kid try to write on paper at their desk and I see the eye leading and their head is kind of turned with the eye facing downward, I immediately raise my flag, thinking, "I need a kaleidoscope to see, you know, can you look through this?" I have them look through it several times, and then I just establish what the eye dominance is.

I also have them build a one-inch block tower, and I have them put Legos and Unifix cubes together. I offer lacing activities and I take the approach of snipping and then cutting a paper in half. I think it's unrealistic to expect them to be able to cut out a full circle if they can't cut at all or can't hold the scissors well. I'll have playdough there so they can practice and understand thumbs up. Then I use an 8-inch playground ball, and I look at their bilateral coordination and how much cueing is necessary if they are able to bounce it and catch or toss and catch. I also observe a lot of jumping, hopping, and balance. I have them kick a rolled ball to look at foot dominance.

You can see that I have to use clinical reasoning through this process. Why? Because I may get a child who doesn't want to do anything; they're scared and uncomfortable with who I am. So I have a lot of things in my bag to try to entice them, which might allow them to explore more and get more comfortable with me. Sometimes I will go out and ask if a parent can come in if that's going to make their performance better. But again, that's a clinical reasoning that I would have to decide on my own. Sometimes I ask for a quick run if I'm curious due to other observations about what's going on with their feet and what their gait looks like. I do a pointing activity to look at ATNR and STNR, and I have them do supine flexion or prone extension. You get a lot of information from this. Then I might have them go from a high kneel to a half kneel, and then I have them point to body parts. Sometimes I do that through "Simon Says." I also use a modified version of the Goodenough Draw-A-Person test, which is a formal assessment. I'm just really looking for what they know about themselves. Many kindergartners are still drawing like a big head with arms and legs coming out of it—it's kind of like a kidney bean with legs and arms but no trunk. So we have to begin to see where they're at in that kind of development.

I also really love to do the soft observations. Can they follow my direction? Does it have to be repeated in a simple command? Do they know how to put their body in position in space? Do they appear to understand that? Do they help me pick things up as I move to the next activity? Do they use the equipment appropriately, or are they distracted? These are all soft things I see, but I think they really help us better understand their approach to the task, their comfort level with materials, and how they are able to maintain their attention and focus for 10 to 15 minutes.

Therapy Collaboration

Where do you start to collaborate for screening? Not all schools are open to it, but I think the point of the screening process needs to be sold. To me, and to the people I work with, the main point is prevention. If we can see what the incoming students are like, we will be better prepared to cope with them when school starts in the fall. We have a pre-meeting to determine what we want to screen. We discuss whether we are duplicating efforts or if that duplication is beneficial.

We receive support from both special education and regular education administration to provide block times for screening and to provide us with the necessary supplies. We have someone send home questionnaires highlighting that some students may have already been involved in early intervention. These come back with the registration materials. An administrative assistant handles the scheduling, so we don't have to worry about it. We receive the sheets on the day of the screenings. I'll tell you, it's much nicer to do it in two-hour blocks, three or four times, rather than a full day, because after a while, you won't remember who is who. We often have the kids' pictures taken with a Polaroid or a camera to help us when we review them later. We must all be comfortable with what we are doing and not "zoned out" after seeing 12 kids.

We use an informational sheet for each child, which includes their name, date of birth, and current age, such as 5.2 or 6.5. This way, we don't have to do the math. Time limits are also important. If you notice you need more time, that's a yellow flag. You have to wonder why this is happening and what behaviors the child is exhibiting that are interfering with your ability to complete the screen within the allotted time.

For the parents who are waiting, reading, or filling out questions, they need a common place to meet. We often use a conference room that is overflowing with attendees in the office space. This can be an excellent spot for them to chat and make their first introductions, knowing their children may be on the same bus. We use stickers for each staff member, so I would know if a child has already been to speech, the special education director, or the incoming kindergarten teacher for screening.

At the end, I always go out and have a brief chat with the parents. I give them the handouts and might suggest things like a specific pencil grip. I can review the handouts to identify what might be good to do. For example, I had one child who had no idea how to use scissors. He told me, "My mommy won't let me use scissors. She's afraid I'm going to cut the curtains." So he was "scissorless." I told her that I totally understood her anxiety, but suggested that if she could work with him in a real, structured way every day, teaching him how to hold the scissors, starting with just snipping, and using hard card stock or Play-Doh, those would be great suggestions. The kids are pretty cute when they've never done something before.

Information the Parent(s) Bring About First 5 Years of Life

Let's consider the information a parent brings to us about the first five years of their child's life. Each school has a developmental checklist, and I believe that the 21st century has changed what we need on that list. I want to add more to that checklist because, as you know, we are raising our kids in a very different way.

I would ask: Did your child ever use a walker? Did they sleep in a sleep sack, and for how long? What was their sleep like? Did they have tummy time? How much screen time does your child have, and at what age did they first use screens? Did your child use a night light? The reason I ask about night lights is that studies have shown that using one from birth onward can cause problems with distance vision. I also want to know if there are any extra concerns the parents or caregivers have, and if the child likes to snuggle and cuddle.

3-Tiered System: Green, Yellow, and Red

I'm going to explain the three-tiered system, which consists of green, yellow, and red. I've given you samples of each to help you understand what we're dealing with, and we'll move forward from there. It was interesting to me while preparing this that I realized green is pretty easy; you know when you're not concerned. Yellow is where you have to take a more in-depth look and figure out what is really going on. Red tends to be more blatant, where it's obvious a child needs an evaluation with no question about it. You'll see that we spend a little extra time on the yellow-flagged children because we're really trying to tease out what is going on with them.

Green Flag

We will begin with the green flag students. These are the students who can complete tasks as expected for their age and grade level, and some may even exceed those expectations. You might notice certain kids withdrawing or doing a full-body drawing of a person. Some have excellent motor skills. Parents are often open to ideas for how to foster those skills over the summer, and I think the handouts we discussed give them something to refer to and understand.

I might suggest using a good pencil grip, breaking crayons, using an easel, or playing with Legos. If you notice a child who is easily distracted, I often ask the parent if this behavior is the same at home or if it's because I am an unfamiliar person. They will usually tell you very clearly whether it's a typical behavior or not. Then I can make suggestions, such as using a timer to help build their attention span. I also inform parents about writing programs. In the case of this particular school, we were doing Handwriting Without Tears. The kindergarten teacher and I agreed that we would send home a strip with the arrows showing how to create the letters, and she made a cheat sheet for language. We told parents that we understand children want to write their names and may already be trying to do so, but the problem is that they will have to undo some patterns they've created. We want to help them develop new habits so they can write more effectively and with greater length. Most parents are very open to this and understand that their children don't need to learn to write letters, but rather know how to create them. We would send that home as well.

Here is an example of a green-flag student named Sky, who is 4 years and 7 months old. When examining geometric formations, she has an idea of form, but the motor strength in her hands could use some improvement. For her pencil grip, her thumb overlaps, and when looking at her eye, hand, and foot dominance, she is right-handed, left-eyed, and right-footed. With ball skills, she's catching, but doesn't have enough strength to return it well. For grasp patterns and other fine motor skills, she needs more practice and precision. Her cutting skills need to be worked on to progress forward. When I looked at her balance, she was jumping, but she needs to know her body more and how she is put together. My notes indicate that she has a lot of questions, is very chatty, and takes pride in writing her name. Her grip is tight, and her left eye is very close to the paper. She is emergent in her four-year-old skills. I suggested some activities from the handouts to help her with her upper-body skills. She will be 4 years and 11 months old when she starts school. She's young, sweet, and willing. My notes help me remember that when we all meet to discuss the children, they know that she's essentially emergent.

For green-flag children, the teachers distributed three self-addressed and stamped postcards to the school and asked the kids to send them a postcard throughout the summer to maintain that connection. The SLP offered a website link to practice phonemic awareness with a video game. The PT offered ideas for 10-minute activities to do on the playground, and I gave them the summer month calendar, which is in your handouts. This could be a collaborative venture where you all decide what you want to do as a group to build a relationship with the parents, since their child will most likely attend that school for their elementary years.

Yellow Flag

Now, here is our yellow flag. This child may demonstrate mild to moderate challenges in one or more of the screenings. The challenges may truly be lagging skills that have affected their ability to perform certain tasks. Any staff member could be the one to tag them. In other words, if I see it and no one else does, that's me tagging them. The input from the team provides the other set of eyes that I referred to at the beginning of this lecture. Therefore, it's crucial to discuss these kids after the fact, as it will provide more information to complement and supplement what you're seeing, or it may prompt you to revisit them to double-check.

Let's talk about James's geometric formation. I marked him as emergent. He's 5 years and three months old, so by April, he'll be close to 5 years and 7 months. He still doesn't have a hand dominance, which is a yellow flag for me at his age. This will affect his motor skills with a pencil. He switched hands and was unable to copy designs. When I saw him struggling with the Slauson, I said, "Okay, can you copy this?" I did a scribble, and he did a scribble. I did a vertical line, and he did the same. I did a circular scribble, and he was able to do it, but when we got to the circle within the circle, that was more challenging. He showed a lot of soft neurological signs, but he still needed imitation rather than a straight copy, and that's so important to note. His pencil grip wasn't great. His hand was switching, his eye is left, and his foot is left, so it appears his left hand may emerge as dominant. I don't push any child to go with the same side; I just watch and see what emerges. I ask parents what hand their child uses to eat applesauce or yogurt or to brush their teeth. This helps me better understand what they are heading for.

He used his hands in a lead-assist pattern, but his ball skills were very inconsistent, as were his grasping patterns. He was more of a three-jaw chuck grabber, and sometimes the other side was more of a gross grasp. He jumped forward four times. He could balance for five seconds on his left and three to four on his right. He hopped on either foot for just one or two hops. He could gallop but had no skipping. He didn't agree to do the ATNR. His core and back strength were interesting. He could get into extension, and he loved me calling him Superman, but there was no way he could hold both arms and legs up. He would try with just his arms and then collapse. So then I'd touch his leg, and he'd try one leg. He wasn't doing well at all and needed a lot of cueing. For core abdominal strength, I called it "snowball" for the kids, but he complained of neck pain after 10 seconds. When I asked him to draw a person, he initially refused. Then I started saying, "Well, draw a picture of Daddy or Mommy," and he needed lots of prompts. When we played the body part identification game, he knew the basics like eyes, ears, nose, and mouth, but neck, shoulders, elbows, and knees and ankles were not clear at all.

Here's what I wrote up after the fact: "He is a delightful, curious, and compliant little boy. Developmentally, he appears to have some weakness in his upper extremity and shoulder girdle area, as evidenced by his tendency to hike his shoulders up when attempting to draw, cut, and copy. Hand dominance is not established, and he switches regularly. It was hard to determine whether crossing his midline is an area of concern, but he did not show any residual reflexes. He held his pencil high and needed prompting to hold it in a thumbs-up position for cutting. He leaned forward, and his body angled backward. He is really easily redirected. We tried a 'twist and write' pencil, which he adapted to well. I sent one home with his mom. He is unable to copy geometric forms. He can imitate my movements and attempt to draw figures. His pencil pressure and general motor skills were poor, resulting in him holding his elbow high and hiking his shoulders. He enjoyed all the activities I had for him, but he needs much more practice and refining. We prompted him to point to body parts, but he just made marks on the paper to draw himself. His hopping was coming along, doing seven hops on the right and three on the left. His jumping was fluid. He could wheelbarrow walk five steps, but he was unable to imitate galloping. Holding his body up against gravity was challenging. With his arms and legs extended, he could assume the posture but not hold it. His reflection was rolled into a ball, and he is left-footed as evidenced by kicking the ball. His ball skills are emergent."

My recommendations were more specific than just the handouts. I provided suggestions for actual games that would be great for him to play that summer, as well as activities that would help him use his arms together. I provided ideas for balls and balloons, using a light mallet to hit a balloon, and aiming and throwing beanbags. I gave them a whole menu of things to try. I also discussed drawing, explaining that we don't want to teach him how to draw, but rather let it develop as he becomes more aware of his own body. Finally, I suggested labeling his left hand as his "worker hand" and his right hand as his "helper hand." The mother also told me that he was sucking his yogurt and eating a lot of squeeze food from pouches. We discussed how using instruments like a toothbrush, a spoon, and a fork can help a child develop their writing skills. I also discussed things to be aware of, such as mirroring. She mentioned that he'd been seen by an ophthalmologist yearly, and it would be a good idea for her to follow up with him. I attached the report with the handouts and explained to her how to contact me through the school.

That's a typical yellow-flag case. I love doing this in the spring because when I return in September, my brain is already refreshed. I can go to his classroom to check in on him or give his mom a quick call to ask, "How was your summer? What did you see? What went on?"

Red Flag

A red flag indicates a student with moderate to severe challenges in one or more screenings, which calls for a more detailed evaluation before or at the beginning of the school year.

An example is Xavier. The moment he walked into the room, I knew something was up. He had no prior preschool experience, and his pre-writing skills showed a general understanding of formation but lacked motor control. When using a pencil, he would smell it. He was easily distracted by pointing out numbers on the clock, constantly shifting positions. His voice was always loud and deep, and he'd swing his head toward me while talking about the numbers on the clock, but he wouldn't make eye contact. He held the pencil with his whole hand, and he was right-handed. He understood how to use a kaleidoscope, but then we got into a tugging match because he didn't want to give it back. I used it as bait, saying, "Okay, let's put it down, we'll do something else, and then you can look at it again." I went back and forth with him like that.

He refused to catch a ball; he wanted to spin it. He would get down on his knees and use both hands to spin it. He declined to lace and build. He tried cutting, but his skills were delayed for his age, and it was hard for him to snip. He tried to jump by holding onto a desk. He didn't want to get on the floor because he said it smelled and was dirty, even though I had a yoga mat down. He refused to do core abdominal strength exercises, even when I tried to engage him as "Superman." He initially refused to draw a person, but when I asked him to draw more, he declined again. He lingered over pointing out body parts. For example, if I said "neck," he would hold his neck and roll his hands over it, and then if I said "hip," he would still be on his neck—almost a perseverative kind of response. Sometimes he would pat the part I called out for a really long time, as if he were giving himself input. My notes on him stated, "I would like to do a full OT evaluation." His mom said this was his first school experience and kept apologizing when I pointed out the challenges I saw.

Every screener found challenges with this child. A red flag calls for a further evaluation, and for the group I work with, that's the start of the clock. We want to have everything in place for when he starts kindergarten. The first step is to make a phone call to the parent to gather more background information and possibly set a date for an evaluation before the end of the school year. Then we determine the best placement for him and whether he needs an educational assistant. This child was evaluated and diagnosed with autism by a psychologist. We immediately started with him in summer school, and I thought it was wonderful that we caught it so early because he had never been diagnosed before, and he was their only child. It was interesting to witness that, and if we didn't have "Child Find" in the state of New Hampshire, we wouldn't have found him.

Research

My research into other school systems has revealed that some schools are indeed offering summer transition programs for incoming kindergarteners to address challenges identified during screenings. I've also seen "step up before K" programs, which have a preschool/kindergarten curriculum. The names and labels for these programs can vary from school to school, but it does make you wonder if some of the yellow-flag kids might do better in a situation like that. If they were to thrive and their nervous system began to respond to the stimulation, you could see them go on to first grade.

Suggestions for Multi-tier Support Ideas for Kindergarten Center Work

In most cases, students need to be part of a multi-tiered intervention or Response to Intervention (RTI) program once they start school. In my experience, I worked with the kindergarten teacher to come in once a week for a preventative session.

I would spend 30 minutes doing a craft the teacher had chosen. We would discuss the best approach to the craft. For example, for Columbus Day, we made the Niña, Pinta, and Santa María. We debated which cutting skills would work, whether they could create curved lines, and whether we would use tracers. Since I already had a caseload in that kindergarten class, I knew what modifications and accommodations I needed to make. We also had a conversation about how we would put it together. We learned so much from one another. The teacher had curriculum data she wanted the students to understand, and I was looking for how they could make the craft as independently as possible. We used to do this thing where we'd hold up the craft and ask, "What materials do you think you're going to need to make this?" In this case, one child would hold up their hand to say "paper," another would say "glue," and another would say "scissors," and so on. We would then have them gather all the supplies and begin working. We would work the room together.

From that weekly visit, I would bring in what the teacher called "OT center time." She had different centers, but if some kids finished early or seemed to need more work on fine motor skills, grasping patterns, or cutting, she would send them to the OT center. Sometimes I had tongs, and they would pick up Unifix cubes. The teacher wanted them to work on groups of ten, so they had to pick up ten orange cubes, put them together, and lay them to the side. Other times, we worked on simple puzzles, used Wiki Stix, Thera-Putty, and Play-Doh machines. This OT center was an extra way to support their development.

For a multi-tiered support system in a kindergarten setting, some activities we used included tongs and tweezers, scratch art, and Jenga with a limited number of blocks. An SLP and I had them blow cotton balls to sight words, letters, or numbers. Each child had their own straw and cotton ball and would blow the ball to a letter of the alphabet lined up on index cards. We also used the game Tensie but with only five dice at a time. For those of you who don't know how to use it, you shake the five dice, look at them, and decide what number you are going to collect. Then you re-shake the remaining dice until you have all of one number. We also tossed coins into buckets three feet away, had them hold three or four coins at a time, and move them down with their thumbs. We sorted playing cards into black and white stacks, then by number, and then we would ask them to find four fives or four eights. We also used Wikki Stix to make mazes, letters, and numbers. We used the game Perfection without a timer. I really enjoyed doing it because I couldn't spend more time treating all of these children, but this was something that was happening in the classroom, and it made me feel wonderful. The teacher and I even started a lending library for games. We could get board games for a dollar at Goodwill since nobody plays them anymore. The kids would take out Twister or Hi-Ho Cherry-O for the weekend and play them with their parents.

What I've presented today may be something you're already doing, or it may be a new idea. It's essential to recognize that each school system differs in its philosophy, approach, and interventions. If you feel the urge to try this, go to your administration and lay out the positive ramifications of doing something like this. We know that teachers are already screening, whether it's the regular education teacher or a special educator. In our case, both did it, sometimes together, and it really did help build rapport.

I think in the 21st century, the river has to run both ways. We are all familiar with neurodiversity and the unique needs of our children, who may not always qualify for special education. However, if we can prevent and meet kids where they are with their abilities and facilitate that, we'll decrease the number of evaluations and IEPs we have to conduct. We're really working smarter, not harder, by participating in this process. Yes, it takes time, but think of the hours we spend in meetings after we do the evaluation and make the IEP. This collaboration may also morph into other areas of your practice. As you learn more about curriculum demands, you'll start to see that when you have to do a pull-out, you'll be doing more based on what those curriculum demands are.

For example, in kindergarten, we want students to know the sequence of the letters. So, I would get big shower curtains, duct-tape them together, and make a huge letter line that kids could jump to. I would say, "Alright, I want you to go down the line, find 'G,' and start there. I want you to jump with your two feet together all the way to 'M.' The only way you can do it is if you say the letters as you jump." I was promoting something they were already working on. We did the same thing with a number line so they could understand addition. I'd say, "Take three little rocks and put them on one, two, and three. Now add two more. What number do you end up with?" I was promoting the idea of their curriculum, and at the same time, I was getting fine motor skills, gross motor skills, grasping patterns, sequencing, and inhibition. I felt like I could go "elbow to elbow" and have those "sidewalk chats" with the teachers because we were both trying to encourage these kids to thrive and meet their curriculum needs.

Conclusion

While this process might seem overwhelming, it's also very gratifying. I've said for years that if our job is to help kids access the curriculum, then it's essential for us to understand what that curriculum is. When we take courses that teachers take, we gain a better understanding of what we're supporting, and we can also break it down and adapt it to meet the needs of the children we work with.

Questions and Answers

Could you explain more about how to test for eye dominance?

To test for eye dominance, you can give a child a paper towel holder, a telescope, or a paper cone and ask them to look through it. You're looking for which eye they naturally choose to look through. If they hold the object in the middle of their forehead, it may suggest they don't have a dominant eye. This is important to note because eye dominance neurologically develops before hand dominance and can affect skills like aiming, throwing, and navigating. I've had personal experience with this, as my father once pointed out that I would push my left eye over to aim when trying to shoot a gun. The aiming eye is responsible for tracking a person's hand as they write, and until writing becomes automatic, the eye will continue to track the hand's movements. This has been researched for years.

Did you ever teach kids how to tie their shoes?

Yes, of course. Living in New Hampshire, if a child can't take their boots on and off, it holds up the entire class and prevents them from getting outside for recess. Therefore, I believe it's a functional skill that needs to be addressed. I would send home ideas and ask parents to work with the child every day. I would also check in to see if they had done it.

Can we use activities that require eye dominance to improve our eye dominance? 

That's a great question. Eye dominance isn't necessarily something you can improve, but you can teach a child to use their aiming eye. For instance, when teaching a child to throw a ball underhand into a bucket, I might suggest that they close one eye to help them aim more accurately. This is what helps me, as I have cross-dominance and find that teaching a child how to aim is a great idea. There's a joke in my family about playing cornhole because I have my right eye closed while my left eye is aiming as I use my right hand.

References

See additional handout.