Push-in To The Classroom! The Why and How for Related Service Providers

Editor's note: This text-based course is a transcript of the webinar, Push-in To The Classroom! The Why and How for Related Service Providers, presented by Kim Wiggins, 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:

• Explain the benefits of providing OT/PT/SLP in a least-restrictive and natural environment.
• Describe at least one effective push-in session by incorporating a push-in model and tips provided in the course.
• Explain a push-in model to plan effective sessions.

Introduction

I am so delighted to be sharing this course with you today, because honestly, this is one of my favorites to teach. The strategies I am going to walk you through were genuinely game-changing in my own career. There was a point when I was completely burnt out as a school-based therapist. I had a huge caseload, I was grappling with so many systemic issues, and I really started to wonder if I was making any meaningful difference at all.

After some soul searching, I decided that if I wanted to see different results, I had to change what I was doing. So I started small. I began pushing into one or two kindergarten classrooms to teach handwriting. Then I started sitting alongside students during academic tasks. And now, after about 10 years of gradually shifting my model, I would estimate that roughly 65% of my caseload involves push-in services. The remaining 35% is still pull-out — because pull-out services absolutely still have their place — but the balance has shifted significantly, and so have the outcomes I am seeing.

Some years the push-in percentage is higher, some years a bit lower; it really depends on the caseload and the particular students I am serving that year. The point is that it has become my dominant model, and I want to share what that transition looked like and give you the tools to make it work for you.

I want to share this journey because I know pushing into the classroom can feel intimidating. You might be wondering: What do I actually do in there? What if the schedule changes? What if I feel like I am just sitting next to a student and not doing real therapy? I am going to give you many ideas and resources, and I hope that by the end of this course, you feel genuinely excited and much more confident about making push-in work for you and your students.

Models of Service: Moving Beyond the Default

There are various ways therapists can provide school-based services. We have consultation, general education classroom-based therapy, special education classroom-based therapy, therapist-directed large-group sessions, small-group pull-out, and individual pull-out sessions. Any of these can be combined with a consultative approach as well. This is not news to most of us. What I want to challenge, though, is the concept I call the "therapist default".

The therapist default is the automatic, go-to recommendation we make as school-based practitioners. Maybe yours is "two times per week, individual pull-out." Maybe it is "one push-in, one pull-out." Whatever the pattern, we tend to carry that recommendation from year to year and build our caseloads around it. I understand why — when we find a structure that feels manageable, we stick with it. But the research is clear: a thoughtful combination of service models, tailored to each student's individual needs, is where we see the greatest benefit. And the least restrictive environment mandate, both legally and ethically, asks us to start there, not to default to the most restrictive option.

Rethinking Pull-Out Services

I want to be clear: I still do pull-out services. They are appropriate in specific circumstances. A student with a significant behavioral challenge who is not making progress in a push-in setting may need a pull-out environment. A student who requires focused work on highly private skills — such as toileting and dressing — may need the privacy of a dedicated space. There are valid clinical reasons to remove a student from the classroom.

But here is what I believe: in school-based practice, individual pull-out sessions should be relatively rare and never the automatic recommendation. When we work with a student one-on-one in a pull-out setting, we are placing them in the single most restrictive environment available. Even a self-contained classroom with an 8:1:1 ratio is less restrictive than a one-on-one pull-out session. The law — specifically the Individuals with Disabilities Education Act (IDEA) — requires that students not be excluded from general education settings simply because it is more convenient or comfortable for us to educate them elsewhere.

I say "convenient for us" intentionally because, if we're honest, pull-outs often feel easier. We are in control of our space. Nobody is watching. It is our room, whether that is a closet, a hallway nook, or a dedicated therapy room. We feel comfortable there. However, that comfort is not a clinical justification.

Group pull-out settings play a role as well — particularly for students who benefit from reduced distraction while learning a new skill, or who need to practice with a small degree of additional stimulation before generalizing to the full classroom. Think about what a group pull-out provides that an individual session does not: a peer is present, which introduces distractions. That peer presence is actually a therapeutic advantage in some cases, because we are slowly building up the student's ability to perform a skill with some competing input before sending them back into a classroom of 25.

Still, none of these models should be our automatic service recommendation. We always want to ask: what does this student need, and what is the least restrictive environment in which they can receive it? If we are recommending a pull-out, there has to be documented justification behind that decision.

The two legal principles I come back to again and again — principles that shaped my own practice shift about a decade ago — are these: Students with disabilities may not be excluded from a general education classroom simply because it is easier to educate them in segregated settings. And schools must make a good-faith effort to include a student in the general education class with services and supports before concluding that a student cannot benefit from such instruction.

Ask yourself honestly: Are you making that good-faith effort? Are you trying the push-in first, then pulling out when the data tells you it is necessary — or are you starting with pull-out and treating push-in as a secondary option?

Why Classrooms Have Changed — And Why That Matters for Our Service Model

I want to take a moment to name something I think many of us, as school-based therapists, feel but do not always say out loud: every year feels harder. The work feels harder. The students can feel it harder. The stress level is higher. And I want to be clear — that is not just the building you are in or the students you are seeing. A significant part of it is systemic.

When we look at what students are expected to accomplish in early elementary school today compared to what was expected in 1980 — nearly 50 years ago — the academic and developmental demands have increased dramatically. The expectations for kindergartners in 2026 are significantly more complex than they were for kindergartners in 1980. And I want to be careful here: kids are still kids. Their developmental timelines have not changed. A five-year-old is still a five-year-old. What has changed is what the system is asking of them.

Here is where this matters directly for us as therapists. Many of us were trained — or still practice — with a framework that made more sense for those earlier, simpler expectations. When classroom demands were less intense, it made sense to pull students out and work on isolated underlying skills in a quiet therapy room. We could address foundation skills in isolation and trust that the student would then apply them when academic demands arose.

But that is not what classrooms look like anymore. The challenges are happening in the classroom — during more intense academic tasks, with more complex multistep expectations, across more demanding settings. If that is where the demands are, that is where our support needs to be. Pushing into the classroom is no longer just a service-delivery preference. It is often the most efficient way to address multiple skills simultaneously and the most relevant way to help students build exactly the competencies they need, when they need them.

What Is a Push-In?

I define push-in therapy this way: Push-in therapy refers to providing related services — like OT, PT, or speech — directly in the classroom or during naturally occurring school activities, allowing students to receive support in the same environments where they are expected to function.

The key phrase there is "the same environments where they are expected to function." That is the heart of it. We are not asking students to learn skills in our room and then generalize them independently into a completely different context with different demands, different distractions, and different people. We are going to them, where the work actually happens.

The Role of MTSS in School-Based Related Services

Before going deeper into the push-in models themselves, I want to connect this conversation to Multi-Tiered Systems of Support (MTSS), because the two are closely linked, and I think understanding that connection makes the push-in model significantly more compelling — especially if you are working in a district that is asking related service providers to participate in the MTSS process.

MTSS is a tiered framework designed to help students make progress before they need a formal related service on an IEP or 504 plan. Tier 1 encompasses universal strategies provided to all students in a general education classroom. The teacher is responsible for implementing those strategies — around things like grip, handwriting, sensory modulation, or social-emotional skills — and ideally, about 80% of students should make measurable progress with them. If fewer than 80% are progressing, the signal is that the Tier 1 strategy itself needs to be reconsidered. That does not mean something is wrong with the kids in that classroom. It means the strategy is not working well enough for the population, and we need to identify what does.

Tier 2 addresses the roughly 20% of students who are still struggling after Tier 1 support. This is where OTPs, PTs, and SLPs often become more directly involved — through targeted push-in sessions, more specific teacher consultation, or, in some districts, screenings. The goal is for about 15% of that 20% to make progress with Tier 2 interventions, leaving only about 5% — often just one or two students in a classroom of 20 — who move into Tier 3 with more intensive, individualized support.

In Tier 3, where that 5% who have not responded to Tier 1 or Tier 2 are served, formal screening and evaluation processes become more appropriate. In my district, screening occurs at Tier 3 to ensure students have genuine intervention opportunities at earlier tiers before moving to more formal evaluation. That approach has worked well for us and has significantly strengthened collaboration between therapists and teachers in the Tier 1 and Tier 2 spaces.

I share all of this because the push-in model is deeply compatible with MTSS. When I teach a sensory modulation lesson to an entire kindergarten classroom, I am operating at the Tier 1 level for all students and simultaneously providing a more direct Tier 2 or even Tier 3 intervention for the one or two students on my caseload who are in that room. One lesson helps 20 kids at once. This is part of the reason why, this school year — I am currently in April as I am presenting this — I have had only four or five screenings across two buildings with a caseload of 60 students. The push-in model, when done thoughtfully and consistently, genuinely nips things in the bud.

An important reminder about MTSS: the strategies have to be used consistently and with fidelity to show any progress. The rule of thumb is that 80% of the classroom should respond to Tier 1 strategies. If a teacher is bringing you six, seven, or eight different students as concerns, that is not a sign that all of those kids need evaluations. It is a signal that the Tier 1 strategies being used may not be working for that classroom, and our role is to help problem-solve at that level first.

The Natural Environment

In a school-based setting, a student's natural environment extends beyond the classroom. It is the hallway, the cafeteria, recess, specials — music, art, PE — and in some cases even the bus. These are all settings where students are expected to function socially, academically, and behaviorally. Contextually based services increase the likelihood that skills will generalize, because the student is practicing them in the actual environment where they need to perform.

Unfortunately, I think many of us — including me — tend to focus our push-in efforts primarily on the classroom. We rarely extend our support into the cafeteria, the playground, or the hallway, often because of scheduling constraints and the pressure to meet students' IEP minutes. I understand that completely. But conceptually, I want us to hold the full scope of the natural environment in mind.

The goal, as I see it, is to move toward a workload model rather than a purely caseload model. A caseload model asks: how many students do I have, and how do I fit them into my schedule? A workload model asks: where are students struggling across their school day, and how can I design my presence in the building to address as many of those needs as efficiently as possible? When we push in, we can provide more interventions across more contexts once we know the classroom curriculum and routines. The investment in learning that context pays forward in the form of far more targeted, efficient, and impactful service delivery.

The 2% Problem: Robin McWilliam's Time Analysis

Robin McWilliam, a researcher who works extensively in early intervention and collaborative service delivery, offers a framework that really clarifies the stakes of where we provide services. If we look at a typical school-age child's day, roughly 12 hours are spent sleeping, leaving 12 waking hours — 50% of the full day. About seven of those waking hours, roughly 28% to 30% of the day, are spent at school. The remaining time goes to social activities, sports, and daily living tasks — eating, bathing, and getting dressed.

Now think about what happens within that school day. The student might receive 30 minutes of OT, which is approximately 2% of their total waking day. Two percent. Extend that to the full week, including Saturday and Sunday when school is not in session, and the picture becomes even starker. The student is receiving OT for a tiny sliver of their total lived experience. So here is the honest question: Is the skill sticking? Is it generalizing? Is this perhaps part of why our caseloads remain large, and discharge feels so elusive — because we are rarely able to discontinue students who are not making enough progress?

I was at exactly that point about 10 years ago. I was not seeing progress. I was not discharging students. They were not meeting their goals. And when I genuinely asked myself why, the structure of my service delivery — isolated pull-out sessions with almost no bridge to the classroom — was at least part of the answer.

Devin and Kevin: Understanding the Impact of Push-In

This is where a comparison I created — and have since brought with me to countless IEP meetings — becomes useful. I call it the Devin and Kevin comparison.

Devin gets one direct pull-out session per week: 30 minutes of individual therapy working on handwriting, grip, and obstacle courses. Kevin gets a push-in. In addition to whatever direct time the therapist provides during the push-in, the therapist is also in the classroom training the teacher and the aide, observing what is actually happening in the learning environment, and embedding small strategic tweaks into activities throughout the week.

Maybe the class is playing Alphabet Bingo. Instead of using the plastic tokens the game comes with, the therapist suggests rolling Play-Doh into small balls and using those as markers, or using tweezers to pick up the tokens. It is a tiny tweak. The students are still playing the same game. But now Kevin is getting bilateral hand use, fine-motor strengthening, and refined grip work embedded in a naturally motivating activity. The teacher learns it, the aide learns it, and it happens across multiple days of the week — not just once.

Over the course of a week, those embedded tweaks accumulate to significantly more intervention minutes than Devin receives in his one 30-minute pull-out session. When I explain this to parents — particularly parents who come into an IEP meeting expecting that "more sessions" automatically equals "more progress" — I show them this comparison. Some parents have raised their hands in those meetings and asked, "How do I get consult added to my child's IEP?" because they understand immediately that consult, paired with push-in, means their child is getting support woven throughout the school day, not just during a single weekly session.

I have this comparison available as a free download on my website, and I encourage you to use it or create your own version. It is a powerful conversation starter.

The Contextually Based and Integrated Services Model

I want to briefly introduce a framework that captures what best-practice push-in service delivery looks like. The Contextually Based and Integrated Services (CBIS) model, developed by Seruya and Garfunkel (2018), provides practitioners with steps to consider when delivering contextual services. There are four components.

The first is information exchange — establishing collaborative relationships, practicing active listening, understanding each team member's perspective, and using clear, accessible language rather than OT or therapy jargon. This is foundational. If teachers do not understand what we are saying or feel talked at rather than partnered with, the collaboration will not work.

The second is exploring context — truly understanding the factors that affect the student's performance in their environment, and conducting observations across multiple contexts within the school day. The student's challenges in math class may look different from their challenges in writing, and both may differ from what happens at recess. We cannot understand a student's needs fully from a single observation.

The third is problem-solving and planning — developing integrated interventions collaboratively with the teacher that address the student's needs within the least restrictive environment. Not just handing over a strategy list, but genuinely thinking through solutions together.

The fourth is feedback — scheduling time to discuss whether the interventions are working, to problem-solve when they are not, and to make adjustments based on real data from the classroom. I want to be transparent: this fourth component is probably our greatest collective weakness. It is genuinely difficult. Contracted therapists running between buildings, classroom teachers with back-to-back instruction blocks, and the absence of scheduled collaborative time in most school schedules all conspire to undermine formal feedback loops.

But here is what I have found: when you push in regularly, the feedback comes naturally. You are in the room. You see what is working and what is not. You catch problems the moment they arise. The push-in model itself addresses the structural barrier that makes the CBIS feedback component so difficult to achieve in a pull-out model.

Push-In Positives

When we push into the classroom, benefits emerge that simply do not occur in a pull-out setting. Let me walk through the ones I find most meaningful in practice.

More practice in context. A student who receives OT in two pull-out sessions per week practices skills for roughly 60 minutes per week, typically with no adult present, and carries forward what was practiced unless we make a deliberate effort to communicate it. When the therapist is pushing in and embedding strategies throughout the classroom day — and the teacher and aide are implementing those strategies because they have seen and heard them modeled in real time — the student is getting intervention support across far more of their school day.

Social relationships are fostered. When I push into classrooms, students across the building get to know me. Kids who are not even on my caseload know who I am and what I do. That familiarity makes an enormous practical difference. When an MTSS concern comes to my desk, or I need to implement a school-wide approach, I am not a stranger. I am someone who is already woven into the fabric of the building. And honestly, it makes me like my job more. There is a different level of professional respect that comes with being visibly present and engaged across the building, rather than existing as the person students get pulled out to see in a room nobody else ever visits.

Students do not miss academics. This is a significant, underappreciated benefit. When we pull a student out of the classroom, we are pulling them away from the instruction their peers are receiving. Students with special needs are often already academically behind, and now we are asking them to miss part of the class, complete their therapy session, and return — only to discover they missed a key explanation or a portion of the activity. They then have to do something extra to catch up, on top of everything else they are managing. That is an additional cognitive and organizational burden on a student who is likely already working harder than their peers just to keep up. Push-in eliminates that burden. The student stays in the room. They stay engaged with the curriculum. The support comes to them.

Teachers see what we do — and learn from it. When we push in, we model strategies in real time, in the exact environment where they need to be applied. Teachers and paraprofessionals learn far more from watching us demonstrate something in their own classroom than they ever will from an email recommendation, a note in the IEP, or a verbal suggestion during a hallway conversation. We often say that therapists are modeling for their students — and yes, that is true. But we are also modeling for every adult in the room. Think about it this way: YouTube is popular because people learn best by watching. If someone needs to know how to change a tire, they are going to watch a video before they are going to read a manual. When we push in, we become the live demonstration that teachers can actually internalize and apply.

We find out immediately whether our strategies actually work. How many times have you given a teacher a strategy recommendation, only for her to say two weeks later, "That didn't work"? Maybe it didn't work because it wasn't being implemented. Maybe it was being implemented incorrectly — the pencil gripper was upside down, the slant board was at the wrong angle, and the spacing tool was lost. Maybe the strategy genuinely does not work for that student in that environment.

When I am in the classroom, I know immediately. I have seen flexible seating strategies that worked beautifully in my small OT group completely unravel in a classroom when the ball chair became a distraction for the five students around it. I have watched pencil grippers get put on the wrong end of the pencil every single day. I have suggested strategies that I was confident would work — because they had worked in my pull-out setting — only to discover that the classroom environment made them impossible. Being present lets me catch those problems immediately, adjust in real time, and save both the student and the teacher from weeks of frustration.

We can work with teachers to address problems as they arise and keep our goals functionally relevant. I cannot count the number of times I have been pushing into a classroom and realized that the IEP goal I have been working toward is not actually addressing the most pressing problem for that student in that setting. Sometimes students transfer to me with goals that were written in a different context. Sometimes an evaluation produces goals that were not fully calibrated to what the teacher actually needs to see this student accomplish. When I am in the room, I can see the real priorities—and update my thinking accordingly.

This is why I always ask teachers to tell me the top three things this student is struggling with in the classroom. Not the top three OT things — just the top three functional challenges. And I tell them explicitly: they do not need to be OT-specific concerns. What is going on with this child in your room? Once I have that list, I can apply my occupational therapy problem-solving skills to determine which area I can address most meaningfully. Sometimes, cutting skills and handwriting are on that list. Sometimes they are not, and the real priorities are something else entirely. Being in the classroom is what surfaces those real priorities. Sitting in a therapy room does not.

Skills are learned in the place where they will actually be used. Think about what we are really asking of a student when we provide a skill in a pull-out session and then expect them to generalize it. Say we are practicing how to form the letter E. The student works on it in the OT room. Then they go back to the classroom for math, then snack, then PE, then lunch, then recess — and then finally they sit down for writing time. Are they going to remember the strategy? Are they going to be able to recognize, in the middle of a writing assignment they are emotionally invested in finishing, that they are not forming the letter correctly — and then self-apply the motor strategy we practiced earlier? That is a significant metacognitive and self-regulation demand, in addition to the actual writing task. For many of our students, that level of independent generalization is exactly the kind of skill they struggle with most. Providing support in the classroom, at the moment writing is actually happening, removes that generalization gap entirely.

Push-In Barriers — And How to Think About Them

I want to be honest about the challenges, because they are real and I have experienced every one of them.

Lack of therapist training is a genuine barrier, and it is one reason courses like this matter. The strategies and structures I am sharing today are intended to help you feel prepared enough to try.

High caseloads are among the most significant structural challenges school-based therapists face. I have had caseloads in the high 80s and low 90s, while simultaneously supervising a COTA and serving as the district's assistive technology person. There are years when the logistics of pushing four kindergartners across four different classrooms and schedules make individual pull-outs the only feasible option. I understand that completely, and I am not here to add guilt onto an already hard situation.

Lack of administrative and teacher support is something we can influence, but it takes time and consistent relationship-building. The momentum tends to build gradually. One teacher sees results, tells a colleague, and that colleague starts asking if you can come into her room, too. I have had teachers hear secondhand about what I was doing in another classroom and approach me to ask if I could do the same thing for one of their students. Word travels, and the more you demonstrate value through presence, the more invitations you receive.

Feeling like a paraprofessional. This is the barrier I hear most often from therapists, and I want to address it directly because it was nearly the thing that stopped me. There was a third-grade student — I will call him Josh — that I had been working with since kindergarten. He struggled significantly with writing: poor spelling, visual difficulties, and trouble getting his ideas on paper. Despite four years of pull-out services, progress had been slow. So I decided to try pushing into his writing time.

In the first session, I sat with him during the writer's workshop. The class had a worksheet with large blank spaces. I reminded Josh of a technique we had discussed before: fold a piece of paper, trace a line along the edge, and now you have a guideline you can write along. No ruler needed. I also noticed he had lost the spacing tool I had given him at the beginning of the year, so I grabbed an eraser and showed him how to place it between words as a makeshift spacer, since finger spacing was difficult for him due to coordination challenges.

I left that session thinking: I just spent 30 minutes giving this child two small, simple strategies. After four years of weekly sessions. That felt like almost nothing.

But when I came back the following week, the girl sitting across from Josh looked up as I walked in and said, "Josh, don't forget your eraser so you can put it between your spaces." She had been reminding him all week. And before I could even sit down, the teacher came over and said, "I heard what you said last time about how he has trouble keeping his writing on a line — so before I made these copies, I added lines to the paper. Are these big enough?"

None of that would have happened in a pull-out session. The girl across from Josh would not have heard me. The teacher would not have known to add lines to the copies. I did not even mention the lines to the teacher — she heard me saying it out loud in the classroom and took the initiative herself. That is what changes when we bring our work into the environment where it matters. That was the biggest aha moment in my entire career. It clarified for me that the goal was never about performing 30 minutes of intensive therapy in the therapy room. The goal was — and always should be — getting the student to make progress, and that is far more likely to happen when the whole environment is participating.

Inconsistent classroom schedules. This is a real and frustrating barrier that I want to name because it happens to all of us. You plan your push-in around writing time. You walk in, and the teacher says, "Oh — we got behind today, we're still in math." Or you arrive and there is a substitute, or the class is doing a special project that has nothing to do with what you prepared. How do you handle that?

First, recognize that you do not always have to redirect the class to your plan. If they are doing reading and you came for writing, look for what you can embed into reading. Maybe the students do their reading while lying on their bellies propped on their elbows on the floor — that is excellent shoulder and core strengthening, which directly supports writing. Maybe you observe while you are there, because you rarely get clean observation time, and this is a gift. Maybe you could add a written response component to the reading activity.

The point is: be flexible, and be a problem-solver. When your plan gets derailed, use your OT brain to figure out what the current activity offers. Almost any classroom activity offers functional opportunities if you look for them.

Collaboration Is Best Practice

Across occupational therapy (American Journal of Occupational Therapy, 2017), speech-language pathology (ASHA, n.d.), and physical therapy (Academy of Pediatric Physical Therapy, 2021), the professional literature consistently identifies collaboration as a best practice standard for school-based service delivery. I include the research from all three disciplines intentionally — because if you are pushing in and your speech or PT colleague is not, that contrast can create confusion for teachers and administrators. When related service providers adopt the push-in model together and frame it as a shared professional standard, it is much easier for the whole building to understand and embrace.

The research findings on consultation and collaboration specifically are worth knowing and being able to communicate to teams and families. Multiple studies examining the outcomes of consultative and collaborative service delivery compared to traditional direct services have produced several consistent findings.

First, consultation by related service personnel has similar child outcomes to direct services. That is a significant finding, and it is one worth having in your back pocket when a parent worries that a consultative recommendation means their child is getting less support.

Second, teacher outcomes are more positive with collaborative approaches than with expert consultation. Teachers do not want to be told what to do. They want to figure things out together. An expert consultation model — where a therapist comes in, provides a list of directives, and leaves — tends to produce less buy-in and less consistent follow-through than a model in which the teacher and therapist genuinely problem-solve together. When teachers feel like partners rather than recipients of recommendations, they are more likely to implement strategies and more likely to continue using them with future students.

Third, teachers benefit from learning new techniques. This sounds obvious, but it matters: when we model strategies in the classroom, we are building teacher capacity that outlasts our service for any particular student. Teachers who learn why proprioceptive input helps a student self-regulate, or how a slant board changes pencil pressure, or why a spacing tool makes writing more legible — those teachers carry that knowledge into every classroom they teach for the rest of their careers. That is a multiplying effect on our professional impact that simply does not occur in a pull-out room.

Fourth, and this one is important for reframing how consultative services are perceived: there is no evidence that consultation requires less time and resources than direct services. In fact, meaningful consultation can require more because it involves attending planning meetings, communicating regularly with teachers, preparing embedded strategies for the classroom environment, and providing ongoing follow-up. Consultation is a different kind of work — not a lesser one.

Finally, consultation supports the generalization and mastery of skills. Because generalization depends on multiple practice opportunities across multiple environments and with multiple partners, and because pushing in directly enables those opportunities, the consultative push-in model is — by design — a more powerful vehicle for durable skill development than isolated pull-out services.

Effective Carryover: Why It Happens and Why It Often Does Not

Let me connect all of this to the concept of carryover, because I think it is the core of why the push-in model matters so fundamentally. When we provide services in a pull-out setting, we rely almost entirely on students to transfer the learned skill into the classroom. We tell the student, " Here is how you hold your pencil. Here is your spacer tool. Here is your strategy for when you feel too fast. And then we send them back into a classroom full of distractions and competing demands, with no other adult in the room who heard any of that.

We are placing the responsibility for generalization on the very student who struggles with generalization. Generalization — applying a learned skill in a new context, with new people, under new demands — is among the hardest cognitive and self-regulatory tasks we ask of students, particularly students with special needs. It is not a small ask. It is often exactly the thing they need the most help with. So why would we design our service delivery to depend entirely on their ability to do it independently?

The practice makes perfect principle is one of the most established concepts in the science of learning. But it is not just about practicing a skill repeatedly — it is about practicing it in a variety of contexts where it needs to be applied. Consider a golf analogy. If you spend an entire season playing the same nine holes at the same course with the same partner, you can become very competent at that specific experience. But the first time you go to a different course, with a different partner, playing different holes, it feels almost like starting over. You have the foundational concepts, but the transfer requires new practice in the new context. The same is true for our students. Practicing letter formation in the OT room and then being expected to apply it during writing time in the classroom, after math, snack, and PE, is asking for a level of independent transfer that many of our students are simply not able to accomplish without support in the new context.

There is also a powerful motivational dimension. Amy Lam (2016) articulated the concept of authentic learning — the principle that students are more motivated and better prepared to learn new concepts and skills when the learning is relevant and directly applicable to their lives. When what we are asking a student to practice is embedded in a real task they actually care about completing, the motivation is built in. When we pull them into a quiet room to work on isolated skills disconnected from the classroom, we lose that motivational engine.

But here is something I do not think we acknowledge enough: this authenticity principle does not only apply to our students. It applies to every adult who is supposed to be supporting the student when we are not there. If a paraprofessional does not understand why we want a student to use a therapy ball for seating — if it just looks like a fun toy and no one has ever explained the proprioceptive rationale — they are not going to enforce it consistently. If a teacher has never been shown how a weighted pencil affects pencil pressure and grip, she is not going to remember to make sure the student uses it. As OTs, we often have a deep, intrinsic motivation for the strategies we recommend. We believe in them. But the people who are with our students for the majority of the school day need that same understanding and belief to make carryover work. Pushing in allows us to explain, demonstrate, and build that shared understanding in real time, in the real environment, where the strategy is immediately visible in action.

Getting Started: Planning Your First Push-In

If you are new to push-ins, or if you want to increase your push-in practice without completely overhauling everything you do at once, here is the approach I recommend. I want to be clear that I did not get to 65% push-in overnight. This has been a gradual shift across more than 10 years, and the most important thing I can tell you is: do not try to change everything at once. You will get overwhelmed and not want to continue. Start small. Get your feet wet. Build from there.

Step 1: Choose a Teacher

Your first push-in should be with a teacher you are comfortable with — someone flexible, open-minded, and willing to have you in their space. Their classroom is like their living room, and being welcomed into it is a matter of relationship. If you are nervous about teaching a whole-class lesson, do not do it in the classroom of someone who intimidates you. Pick a friend, or at minimum someone who is friendly to you.

Also, confirm that the classroom has at least one student on your caseload. If you are pursuing a push-in as an MTSS Tier 2 intervention rather than direct therapy, that is not strictly required — but for direct therapy, you need to be able to tie the session to a student on your caseload.

As you build confidence, word will travel. I have had teachers hear secondhand that I was doing something in another classroom and come ask me to do the same in theirs. Relationships and visible results are the most powerful advocacy tools we have.

Step 2: Identify Student Needs and the Right Setting

Talk with the teacher. Ask for the top three things this student is struggling with in the classroom — again, not just OT things, just the three biggest functional challenges from her perspective. Once you have those priorities, look at the student's daily schedule and identify when those difficulties are most active. That is your push-in window.

Give yourself permission to start with subjects and activities you feel comfortable with. If math makes you nervous, do not start with math. Start in writing time, or during a center rotation, or during a routine you already understand well. As you build confidence and learn the classroom's rhythms, you can expand.

Step 3: Choose a Push-In Model

Once you know your teacher, your student's needs, and your setting, the final step is selecting what kind of push-in you are going to do. For the rest of this course, we are going to go through each model in detail, with specific examples and ideas.

The Six Push-In Models

In my experience, there are six distinct push-in models. Each has its own structure, advantages, and appropriate use cases.

Model 1: Therapist Led

In the therapist-led model, the therapist plans and delivers a lesson to the entire class. The therapist is the instructional lead—essentially, the therapist serves as the teacher for that session. The classroom teacher should always remain in the room, actively observing and listening, and not use the time to run errands or make copies. This is a requirement, not a preference. The whole point of the therapist-led model is that the teacher hears the same language, sees the same strategies, and understands the same rationale that the students are receiving — so she can reinforce all of it for the rest of the week when we are not there.

Therapist-led sessions come in two formats.

A routine activity is a lesson type already built into the classroom schedule that the therapist takes over for one session per week. For example, every Monday, the class has a writers' workshop, and the OT comes in to deliver a handwriting lesson — paper positioning, pencil grip, directionality, and motor planning for letter formation. It fits naturally into writing instruction. The teacher does not need to carve out extra time; the therapist simply takes a turn leading what would already be happening.

A unique activity is something new added to the weekly schedule — a program or curriculum that the therapist introduces to supplement the students' education. The teacher creates a time slot — perhaps Tuesday at 10:00 a.m. — and the therapist teaches the entire class a sensory modulation curriculum, such as Just Right! A Sensory Modulation Curriculum for K-5, or the Zones of Regulation, or a yoga sequence, or a fidget tool lesson. These are unique activities that were not already part of the classroom routine but are added because they serve a genuine educational and therapeutic purpose.

The reason the whole-class approach matters so much goes back to the carryover principle. If I teach sensory modulation in a one-on-one pull-out session, the only adult who hears the vocabulary is me. When my student returns to the classroom and says, "I need proprioception," nobody knows what that means except for that child — and they may not know how to get it on their own. But when I teach the whole class what proprioception is, what activities provide it, and when you might need it, the whole classroom shares that language. Joey knows it, Sarah knows it, and the teacher knows it. When Josh says he needs some proprioception, everyone supports him in accessing it. That is a carryover that happens naturally, embedded in the classroom community.

This year I teach handwriting to nine classrooms per week — two transitional kindergarten classrooms and all of the kindergarten classrooms. Kim's Weekly Kindergarten Handwriting Plan is on my website under Freebies, and you are welcome to use it or build your own. This consistent presence in those classrooms is part of why I have had so few MTSS screenings this year. Getting into the classrooms early and often means I catch developing concerns before they become formal referrals.

The following table summarizes examples of routine and unique therapist-led activities across disciplines:

Large-group functional skill ideas for OT-led sessions include handwriting lessons, typing instruction (there are many free and AI-generated options, and websites like Accessible Chef also provide accessible visual formats for functional tasks), cooking groups, desk clean-out lessons, and pre-vocational tasks like filing papers and stuffing envelopes for older students.

Cooking groups deserve extra attention. For the past several years, the speech therapist and I have co-treated weekly cooking lessons in both of my self-contained classrooms for students with autism. If I can teach cooking, truly, anyone can. These sessions target the following multi-step directions, fine motor skills, sequencing, vocabulary, utensil use, sensory processing, and a wide range of functional daily living skills. We rotate the planning responsibilities — OT one week, speech the next, teacher after that — so no one person carries the full burden. Resources I rely on include the Accessible Chef website (free, with visual recipe formats), Kim's Pinterest Cooking With Kids board, and Life Skills Simulations from Teachers Pay Teachers. And if a session feels light on OT content, add dishwashing. It is bilateral coordination, fine motor, tactile, and proprioceptive input all at once, and it is a genuinely functional life skill.

Large-group social-emotional and sensory options include the Just Right! curriculum (K-5) and Just Right! Jr. (for emerging learners), Zones of Regulation, Superflex, fidget tool lessons, yoga, Brain Gym, and structured movement breaks using sensory paths or motor labs. For movement break videos, YouTube resources like PE Bowman, Coach Corey Martin, and Cosmic Kids work well, and the platforms Teachflix and Just Adapt It (which formats movement content similarly to a streaming service) offer additional organized options.

Model 2: Co-Teach or Co-Treat

The co-treat model pairs OT, PT, and/or SLPs in a shared session, with each discipline targeting different students during the same activity. For example, in a structured movement break, the OT addresses self-regulation and sensory processing, the PT designs and leads the gross motor components based on the IEP students' goals, and the SLP provides multi-step verbal directions and targets vocabulary and communication throughout the activity. Everyone is doing the same thing, but each therapist is documenting and billing for the students they are specifically targeting.

I always say: moving makes them talk. Motor activities naturally create rich communication opportunities, and OT-SLP co-treats in movement sessions allow both disciplines to work simultaneously without either one compromising their clinical focus.

One resource I find especially useful for planning cross-disciplinary co-treat sessions is Learn to Move, Move to Learn by Jenny Clark Brack. It organizes activities by sensorimotor theme and explicitly identifies which skills each discipline can target in each activity. I also compiled a "Books with Motor Activity" resource on my website — it lists children's books that naturally lend themselves to embedded movement sequences, which allows the SLP to lead the literacy component while OT leads the motor component.

For billing, the most common arrangement is for each co-treating therapist to identify and document specific students in advance. In a large group, OT takes two students, and speech takes two different students. In some districts, there is flexibility in how this is handled — follow your district's guidance on co-treatment billing.

Model 3: Embedded Small-Group or Station

In this model, the therapist takes responsibility for one center or station in a rotating small-group structure that is already part of the classroom routine. This is especially natural in primary grades, where center rotations are a regular part of the schedule. The therapist designs their station to align with the class's current instructional focus — the same content the other centers are addressing — while embedding the student's IEP goals into the activity.

The therapist's students can be handled in different ways. In some cases, the therapist's IEP students stay at the therapist's station while other students rotate through. In other cases, the therapist's station is simply one of the rotating stops, and the IEP students pass through it like everyone else, with the therapist providing individualized cueing and support while they are there.

For example, if the class is doing an ELA reading center rotation, the OT might set up a station using alphabet dough stampers and moon sand on a cookie sheet, magnetic letters on a metal tray, or Wodo clay to build and manipulate words. Students are working on the same literacy content as the rest of the class, but with rich fine motor, tactile, and visual-motor demands embedded in the activity. You can also use beading activities to form words, or dry-erase markers on magnetic block cubes, or painter's tape on a cookie sheet to create Elkonin boxes for phonological awareness work.

That last idea came directly from attending a grade-level team meeting. Teachers were discussing Elkonin boxes, and I did not know what they were. I looked it up, realized they were sound-segmentation boxes used for phonics, and immediately started brainstorming how to make them proprioceptive and sensory. We ended up using magnets on cookie sheets, painter's tape to create the boxes, and magnetic block cubes that connect with a satisfying tactile snap. I would never have thought of any of that without being in the room with teachers. That is what genuine collaboration looks like.

I attend grade-level team meetings occasionally — maybe once a month — specifically to stay connected to what teachers are working on. It has been one of the most valuable professional practices I have developed.

Motor center resources I recommend include the 50 Fine and 50 Gross Motor Classroom Center Ideas from Inspired Treehouse, and a Push-in Motor Center Resources spreadsheet I have compiled and made available through my website. It has tabs for different activity categories and is designed so you can check off what you have done during the school year and plan what is coming next.

Model 4: Therapist Adapts Materials and Supplements Instruction

In this model, the therapist works with the teacher to adapt the materials or structure of an existing lesson rather than delivering new content. This requires the most advanced planning and collaboration, but it is highly effective — especially for older students who may be transitioning from direct therapy to a consultative model.

A concrete example: the teacher is planning a unit on amphibians. The OTP adds lines to the blank spaces on all the worksheets before they are photocopied. The PT adds a movement component to each question on the activity sheet. The SLP simplifies the written directions on the handout and creates a visual support. The student participates in the same lesson as the rest of the class, with individualized supports built invisibly into the materials.

Embedding strategies are the most granular application of this model. These are the small, targeted tweaks I am always talking about — the ones that individually seem minor but cumulatively make an enormous difference.

Adding a slant board changes the angle of the writing surface, which affects wrist position, pencil pressure, and visual alignment for students who struggle with writing on a flat horizontal surface. A slant board does not have to be purchased; a large three-ring binder positioned horizontally under the paperwork works just as well.

Spacing tools — an eraser, a pencil cap, a rolled strip of paper, or a finger-width spacer — help students maintain consistent word spacing without relying on fine-motor and spatial-awareness skills they may not yet have. I regularly add a spacing tool to IEP plans and 504s.

Scissor skill adaptations include cutting against the wall, which automatically positions the elbow correctly and removes the need for wrist stabilization. I have seen students who appeared to have significant scissor difficulties demonstrate near-typical cutting performance when I simply had them hold the paper against the wall and cut from the bottom up. It is not magic — it is a biomechanical accommodation.

Paper modifications are one of my highest-leverage tools, and I want to spend some time on them because I think they are underutilized.

Darkening lines — top, bottom, or both — gives students with visual discrimination difficulties a clearer boundary for letter sizing. Adding a dotted center line helps students who struggle with midline placement of letters. Highlighting the bottom portion of the writing line gives a tactile and visual cue for baseline anchoring. Adding a colored dot at the left margin provides a visual anchor for directionality. Using Wikki Stix to create a raised line gives a tactile cue as well as a visual one.

The writing window is one of my simplest and most effective tools. I make them on the spot: take a piece of paper, fold it in half, cut a small notch from the fold that opens into a rectangle. When the paper is unfolded, you have a window. The student places the window on their writing paper so that only one line is visible at a time, writes on that line, then moves the window down to the next line. It limits visual overwhelm and keeps the student's focus exactly where it needs to be.

I recently used a writing window with a first-grader during a push-in session. When she finished her paragraph and brought it to the teacher, the teacher asked, "Did she do this by herself?" Yes — she wrote every sentence independently. When other students nearby saw the writing window and said they wanted one too, I quickly made extras from construction paper. What started as an individual accommodation became a classroom tool in about three minutes.

One accommodation I recommend adding to every 504 plan and IEP for students who need paper support: "Add lines to blank spaces on worksheets or writing areas." This single sentence is a game-changer, and it costs nothing.

Environmental modifications are another application of this model. Reducing unnecessary sensory stimulation in the classroom environment can meaningfully support students with sensory sensitivities — and often benefits all students. Recommendations include using dim or natural lighting when possible, reducing visual clutter on walls and in the physical space, keeping materials organized in labeled bins, offering noise-canceling headphones for students who are over-responsive to auditory input, and providing calming background music during independent work times. A **calm-down corner** — a designated low-stimulation space with sensory tools and a timer — is an environmental modification I use frequently, but I want to emphasize: any environmental tool needs to be explicitly taught. Do not put a calm-down corner in the room and assume students will know how to use it appropriately. Come into the classroom and teach it. What is this space for? When would you use it? What do you do while you are there? What happens when the timer goes off? I sometimes teach this directly in a classroom push-in session rather than leaving it to the teacher.

Model 5: Therapist Assists

This is the model most people picture when they hear "push-in." The therapist sits alongside a student and supports them through whatever activity the class is already doing — providing modifications, cueing, adaptive strategies, and clinical observation as needed. The teacher continues to lead the lesson. This model requires minimal planning; you show up with your push-in bag, assess the situation, and apply your clinical reasoning to the activity.

The key difference between a therapist sitting next to a student and a paraprofessional doing the same is the quality and specificity of the clinical thinking you bring to that seat. Your OTP brain is simultaneously tracking pencil grip, paper position, postural alignment, visual tracking, frustration tolerance, sensory state, and functional participation. You are making real-time clinical decisions about when to provide a cue, what kind of cue to provide, when to introduce a tool, and when to step back and let the student work independently. None of that is visible from the outside, but all of it is happening.

If a student has a one-on-one aide, a push-in assist session is also an ideal opportunity to provide training and modeling for that aide. The aide is watching you. They are learning what you do and why. When you are not there the next day, they can apply what they observed. That multiplying effect is clinical work — even when it looks like sitting.

Some OT-specific assist tips for common classroom contexts:

In ELA at younger grades, look for ways to embed fine motor and sensory activities into existing reading and writing center structures.

During writing time, focus on paper position, pencil grip, letter formation, visual scanning, and spacing. Paper modifications and positioning tools are your primary toolkit here.

During math, support the use of manipulatives, address visual-spatial organization on the page (the adapted hundreds chart I created and now offer as a free download has been especially useful here), and look for opportunities to embed fine motor demands into the activity.

When assisting students at their seats or at stations, especially in younger grades, look for ways to turn the activity into a small-movement challenge. Have the student bear-walk or crab-walk to retrieve materials. Position something they need to reach across the room so they have to get up and bring it back. Small proprioceptive additions to a static activity can make a significant difference in a student's arousal and attention, and they take no extra planning time.

Model 6: Pull-Aside in the Classroom

The sixth model is the least push-in-like of the six, but I include it because it is a legitimate option and sometimes the right clinical choice. In this model, the therapist works with a student or small group in the back or side of the classroom on a task that may or may not align with what the rest of the class is doing, while physically remaining in the room with the class.

The student is present in the same space as their peers, which means the environmental context — peer voices, ambient movement, visual stimulation from the rest of the class — is added to the activity. This provides more context than a fully isolated pull-out session, and for some students, this gradual introduction of environmental complexity is exactly the right therapeutic step.

I think of the pull-aside as a transition strategy—a bridge for a student moving from a traditional pull-out to fuller classroom integration. If a student is not yet ready to participate in the full classroom activity stream, you can begin by gently pulling them to the side while keeping them in the room. Over time, you can move from the side toward the back, from the back toward a table with peers, and from that table toward full integration into the class activity. Each step adds more context and complexity, scaffolded by your clinical judgment about what the student can currently manage.

Goals That Promote Push-In

One of the places OTPs get stuck when shifting toward a push-in model is that their existing IEP goals do not easily translate to classroom-based intervention. If the goal is "Student will cut out a circle with accuracy in 3 out of 5 trials," that does not naturally map to a classroom push-in setting. And if we are being honest, cutting circles is probably not among the top three priorities that the teacher mentioned when you asked what was going on with that student in her room.

Goal writing and push-in planning have to evolve together. As you begin pushing in and observing students in their natural environments, your understanding of what actually needs to be targeted will sharpen. When it is time to update IEP goals, write them in ways that reflect classroom function — and write them so they can be measured by classroom staff, not just by you.

Here are sample goals written to support push-in service delivery:

To improve written expression skills, Zachary will visually scan the keyboard to accurately find and type the letters of his first and last name in sequential order when completing written work in the computer lab, with fewer than three verbal prompts, in 2 out of 3 consecutive days as measured by a checklist completed by classroom staff, by June 20XX.

To improve visual scanning skills, Kara will identify her name on her cubby when asked to find it, with one verbal prompt, in 9 out of 10 consecutive days as measured by a checklist completed by classroom staff, by June 20XX.

To improve copying skills, August will copy a math problem from a far point onto graph paper with proper alignment, allowing no more than 1 number omission and no more than 2 cues, in 4 out of 5 consecutive trials by June 20XX.

To improve sensory sensitivities, Anne will tolerate an arts-and-crafts activity involving glue for up to 5 minutes without yelling or running away, with no more than 1 verbal redirection, in 2 out of 3 opportunities by December 20XX.

Each of these goals is anchored to a classroom activity and can be measured by classroom staff. None of them requires a therapy room. And each targets something that would actually appear on a teacher's top three functional concerns list.

Using Natural Times

If you are struggling to identify push-in windows in a crowded school schedule, I want to offer two settings that many therapists overlook: recess and the cafeteria. Both are natural environments where sensory, social, motor, and functional skills are in high demand — and where our support can have a significant impact. Programs like Refreshing Recess and Comfortable Cafeteria through Every Moment Counts (www.everymomentcounts.org) provide structured frameworks for delivering related services and consultation in these settings. Do not overlook recess and the cafeteria just because they feel outside the traditional therapy frame. They are natural environments. They count.

Practical Tools for Push-In Success

Create a Lesson Plan

When you are leading a large-group push-in — particularly for the first time — write out a lesson plan. This sounds basic, but it matters more than you might expect. Over 25 years of practice and 20 fieldwork students mentored, I have seen capable therapists get completely flustered standing in front of 20 kindergartners because they did not have their materials organized or their sequence thought through. They forgot what to say first. They could not remember which activity came next.

A simple, clear lesson plan — goals, materials, step-by-step sequence, anticipated student responses, and how to handle them — builds your confidence and keeps you organized. It does not have to be elaborate. A simple list of: which of the six push-in models you are using, what goals you are targeting, what materials you need, what you will say and do in order, and what your backup plan is if the class is not doing what you expected. That structure is what the push-in lesson plan template on my website provides.

Build a Push-In Bag

Always have a push-in bag with you when you go into a classroom. You will not open it every time. That is fine. But you need to have it available, because you genuinely do not know what activity you are walking into on any given day, and being caught without tools is a barrier that will erode your confidence over time.

Here is what I recommend putting in your push-in bag: a variety of pencils (golf pencils, regular pencils, weighted pencils), pencil grippers, a pencil sharpener, finger spacers, a thick black marker for adding lines to worksheets on the spot, a highlighter, both right- and left-handed scissors, chalk, flip crayons, weighted pencils, rubber tubing, gum, movement break cards, Wikki Stix and/or pipe cleaners, stress balls and other fidgets, colored overlays, a small vibrating back massager, Theraputty, erasers, a folder with adapted paper, extra worksheets as backup, and mini Magna Doodles.

SLP and PT colleagues have their own versions of the push-in bag — you can find those lists on my website as well.

Tips from Teachers and from Me

After 25 years as a school-based OT and having mentored more than 20 fieldwork students, here is the practical advice I give everyone going into their first push-in experience — and the advice I still give myself.

Be flexible and be willing to abort the plan. I am a self-professed control freak, so this has been my ongoing personal challenge. Your plan will not always survive contact with the classroom. Be prepared to adapt, observe, or embed what you can into whatever is actually happening.

Do not recreate the wheel. So many excellent resources already exist from organizations like Inspired Treehouse, Every Moment Counts, and others. Adapt and build on what is already out there rather than starting from scratch every time.

Be positive. Leave whatever is going on in your day at the door. Teachers and students need a warm, engaged presence from you, and how you carry yourself when you walk in makes a real difference.

Try not to be distracting. I have to remind myself of this regularly because I have a loud personality. If your strategies or tools are attracting students who are not your focus, redirect quickly—distribute the tool to the whole class, move yourself, or adjust your approach.

Come in with ideas and have backups.** Sometimes what you prepared for will not happen. Have at least one or two alternative ideas ready, so you are never standing there without a plan.

Do not be afraid to talk to the whole class. They are six, nine, and eleven years old. You can address, redirect, and engage them. For some therapists, this takes genuine getting used to, but it becomes natural quickly.

Be helpful in a general sense. If something drops, pick it up. If a student needs a tissue, grab it. Teachers are managing 20 to 30 students all day long, and an extra adult who is genuinely present and helpful is always welcome. Be that person.

IEP Considerations for Push-In Services

A question I receive frequently is: "My IEP says direct individual services — can I still push in?" In most cases, yes, with attention to language and documentation.

Direct individual does not automatically mean in a therapy room. You can provide direct, individualized services to a student while that student is in the classroom, engaged with the class activity. You are still targeting that student's specific goals. The location is different; the directness and individualization are not.

If the IEP specifies the location of services as "in the therapy room," check with your district's IEP-building system. Many of these systems use a default language that can be modified. In my district, I worked with staff to change the default language to "in/out of the classroom," giving me the flexibility to accurately document push-in and pull-out services. Before that change, I would document one session as a pull-out and one as a push-in, which allowed me to accurately represent both service types.

If the IEP is genuinely written in a way that does not support push-in, the appropriate step is to raise it at the next IEP meeting. Advocate for language that reflects the least restrictive environment mandate — because that is precisely what push-in services are designed to serve.

Conclusion

Push-in services are not a trend or a stylistic preference. They are the model that the law supports through IDEA's least restrictive environment mandate, that the research validates through the literature on consultation and collaborative service delivery, and that our students need in order to truly generalize the skills we are working so hard to build.

Returning to our learning outcomes: We have explored the benefits of providing services in a least-restrictive, natural environment — from increased practice opportunities and more durable carryover to stronger relationships with teachers and peers to alignment with IDEA and the professional standards of OT, PT, and SLP. We have described each of the six push-in models — therapist-led, co-treat, embedded station, materials adaptation, therapist assist, and pull-aside — with concrete examples and practical strategies. And we have walked through a framework for planning effective push-in sessions, from selecting the right teacher and setting to choosing your model, building your push-in bag, writing classroom-based goals, and navigating the IEP language considerations that sometimes make practitioners nervous about trying this approach.

If you take nothing else from this course, take this: you do not have to change everything at once. Start with one classroom, one teacher, one session. Give two small strategies. And then come back the following week and see what happened while you were gone.

I guarantee that something will surprise you. And when it does — when the student across the room reminds your student to use his eraser, or when the teacher adds lines to the copies because she heard you say it out loud — you will understand exactly why I made this model the center of my practice, and why I have never looked back.

References

See additional handout.