Karlie Froseth, MOT, OTR/L, Occupational Therapist, Prairie Grit Therapy
A TEACHER'S GUIDE, PART 2 OF 2
Start with the room, not the child.
Most of what helps one struggling student helps eight others, costs nothing, and requires no referral. Run those changes first. If the behavior improves, the room was a meaningful part of the problem, and you have learned something useful without anyone being evaluated.
Part 1 covered how to read the behavior. This article covers what to do next.
Seven changes that work classroom-wide
1. Make the schedule visible and keep the order
Post it where students can see it, in pictures or words depending on the grade. Follow the same sequence daily. When it changes, say so in the morning rather than at the moment of change.
Predictability is not rigidity. It is the thing that frees up capacity for the actual work.
2. Warn transitions with numbers
Five minutes, then two, then now. Specific counts work better than general ones, and a visible timer works better than a spoken warning for students who process time poorly.
Give the warning to the room, not to the one child. Singling out a student turns a support into a spotlight.
3. Build movement in before you need it
Movement given on a schedule works. Movement given after a meltdown teaches the meltdown.
Jobs that involve resistance and weight settle bodies more than free movement does. Carrying a stack of books to the office, pushing in chairs, wiping the board, moving a bin, carrying the lunch tub. These read as helpful rather than as accommodations, which matters socially.
4. Offer real seating choices
Standing, floor seating, a different chair, a spot at the back where movement is less visible. Let the choice be available to everyone and stop tracking who uses it.
5. Separate the writing from the knowing
When writing is not the skill being assessed, reduce the writing. Oral answers, scribing, typing, fill-in rather than full sentences, fewer problems that measure the same thing.
A student who understands the content and cannot produce it on paper is failing an assessment of handwriting, not of content.
6. Build a calm spot and protect what it means
Define a space in the room a student can go to reset. Available to anyone, no permission negotiation, no logging.
The moment it is used as a consequence, it stops working, permanently. A student who has been sent there in anger will not go there voluntarily again.
7. One instruction, one visual
Multi-step verbal directions are a working memory task before they are a compliance task. Give one step, pair it with something written or drawn, and check for the start rather than the finish.
What tends to backfire
Common responses that make the pattern worse
Removing recess from the student who most needs to move
Correcting publicly, which adds social load to a child already at capacity
Reminding repeatedly, which addresses knowledge of a rule that was never the problem
Sticker charts used alone, which reward a skill the child does not yet have
Escalating volume, which raises arousal in a room where arousal is already the issue
Sending home a daily behavior report with no strategy attached to it
None of these are failures of care. They are the standard toolkit, and they work fine when the problem is motivation. They do not work when the problem is capacity.
Sometimes it is not sensory and not a disorder
Credibility requires saying this part.
Some behavior is age-appropriate and will resolve without intervention. Some are a child that is hungry, a tired child, or a child whose morning at home was chaotic. Some are from tasks that are genuinely too hard, which is information about the task.
Not everything needs a referral. Persistent patterns that do not respond to good classroom practice are what need one.
Talking with the family
This conversation goes wrong in predictable ways, and most of them are fixable.
Lead with something specific you like about the child, and mean it
Describe what you see rather than what you think it means
Ask what home looks like before you offer a theory. They may have information you do not
Avoid diagnostic language entirely. That is not your role and it puts families on the defensive
Frame it as a question you want help answering, not a verdict you have reached
Say what you are already doing in the classroom. Families need to hear that the work started before the phone call
Many families have heard from schools before. Assume the conversation is already in progress.
What to document before you refer
Bring this to the team meeting
What you see, described in plain observable terms rather than labels
How often it happens and how long it lasts
When and where it clusters
What typically happens in the minute before, and in the minute after
What you have already tried, and what changed when you tried it
What the child is like on a good day, and what was different about that day
Describe behavior rather than diagnosing it. “Leaves his seat 12 times during independent math, usually within two minutes of starting” is useful. “He has sensory issues” is not, and it is outside what any of us should conclude from a classroom observation.
Where occupational therapy fits
School-based OT supports access to education. If a child's participation in the school day is affected, that is the door.
We look at motor skills, sensory processing, regulation, and the specific demands a school day makes. Sometimes the recommendation is a strategy you run yourself. Sometimes it is direct service.
School services and outpatient therapy are different systems with different eligibility rules. A child can qualify for one and not the other.
Talk to your building team about your referral process. Your documentation is the most valuable thing you bring to it.
The reframe worth keeping
Children generally do well when they are able to.
When a child is not doing well, something is in the way. Your job is not to determine what is wrong with them. Your job is to notice the pattern, adjust what you can, and bring a clear description to people who can look further.
You are already doing the hardest part, which is paying attention to a child who is difficult to pay attention to.
Start here
The first article covers what behavior is buying, eight common presentations and what sits underneath them, why quiet students get missed, and how to find the pattern.
Prairie Grit Therapy provides pediatric occupational, physical, and speech therapy in Minot, North Dakota.