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Welcome to the show notes for the Episode 63 of the OT School House Podcast.
In episode 63 of the OT School House Podcast, Jayson interviews a leader in the sensory integration community. Dr. Susanne Smith Roley, OTR/L, OTD, FOTA joins the podcast to talk about how she came to know and love both occupational therapy and sensory integration. We also talk a bit about the history and future of SI. We even address the difficult topic of how and why sensory integration has been criticized over the years within the profession and Dr. Roley provides great insight into the research and fidelity within sensory integration. We finish off this podcast with a discussion on Independent Educational Evaluations (IEEs). Listen in for a valuable experience!
Links to Show References:
Sensory Integration and the Child (Book - Affiliate Amazon Link)
Episode 25 of the OT School House Podcast With Zoe Mailloux
Episode 26 of the OT School House Podcast With Kelly Kelly Auld-Wright
Evidence-Based Practices for Children, Youth, and Young Adults with Autism Spectrum Disorder ©2020
Building Competency in SI (OT Practice Article) Shared with permission from the Author
Transcript
Now you can read the transcript here or download it.
Please note that this translation was auto-generated and may not reflect exactly what was said on the podcast.
SPEAKERS
Amazing Narrator, Susanne Smith Roley, Jayson Davies
Amazing Narrator 00:01
Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy, tips, interviews and professional development. Now to get the conversation started, here's your host, Jayson Davies, class is officially in session.
Jayson Davies 00:18
Hello, Welcome everyone to Episode 63 of the OT school health podcast. Thank you all so much for being here with me today. I really appreciate that. We have a really great episode we actually have on an industry leader in the field of sensory integration today. It is Dr. Susanne Smith Roley. And I'm going to introduce her in just a moment, we're going to talk all about sensory integration, how it kind of came to be a thing a little bit, how she got involved with it, where it's going in the future. And then we're also going to talk about independent educational evaluations a little bit she provides IEEs is here in Southern California. So I'm going to pick your brain on IEEs, so stay tuned for that. But first, I wanted to make just a few quick announcements. I want to thank all of you that have already signed up for the back to school conference in August. Super exciting, I can't wait for it. I have received a frequently asked question about it. And that is Will I be providing continuing education units for it? So I want to make it clear right now Yes, I will be providing a certificate of completion for going. Currently it is not AOTA approved. I am working on that. But just keep in mind that NBC OT and most states don't require professional development to be AOTA approved. That being said, I am in the process of working on that. And trust me, I will make a big announcement when it is AOTA approved crossing my fingers. hopefully within the next few weeks that I can do that. All right. Second thing is big announcement to his transcripts, I am now going to be producing transcripts for the OT School House podcast. So if you hear something and you just want to be able to read it as well, be sure to check out the show notes for this one OT schoolhouse.com forward slash Episode 63 you will be able to either view the transcripts right there on the page or download a copy for yourself so you can read it. And I don't know anywhere else you might want to read the transcripts. All right. So that is a little bit of housekeeping for today. Let's go ahead and move on now to my introduction for Dr. Susanne Smith Roley.
Jayson Davies 02:22
Alright, so Susanne is an occupational therapist with over 40 years of experience in pediatric practice specializing in child development, sensory integration, learning difficulties, visual impairment and autism. She obtained her Bachelor in science and OT at Indiana University, her master's in Allied Health Sciences at Boston University and her OTD at the University of Southern California Susanne practices and a private practice in Orange County, California serving children and families through evaluation and consultation services. She was certified in SI sensory integration in 1977, having studied under Dr. Aging errs, who of course we've all heard of. She later co-founded and directed the USC WPS sensory integration certificate program for 15 years. She is currently the co-founder and president of the nonprofit organization Collaborative for leadership and sensory integration, also known as CLASI which we will also talk about a little bit later today. She is a past chair of the Commission on practice and the sensory integration special interest section for AOTA and a contributing author of occupational therapy practice framework domain and process from 2002 and 2008. So she really helped to lay the groundwork for the new OTPF. She is an internationally recognized author and lecturer and co editor of books understanding the nature of sensory integration with diverse populations and sensory integration, applying clinical reasoning to diverse populations. She's a fellow of the American OT Association, and recipient of the American OT Foundation, Virginia Award of Excellence and the American occupational therapy foundation aging airs award. So please help me to welcome Dr. Susanne Smith. Roley.
Jayson Davies 04:03
Hello, Dr. Roley. Welcome to the OT schoolhouse podcast. How are you doing today? I'm good. Jason, thank you for inviting me. Thank you. Yeah, I'm so happy to have you on. And I must say I don't think any occupational therapist or Occupational Therapy Assistant even can graduate out of school without seeing your name somewhere, whether it's in a textbook, or on a article, you have many, many I was actually just looking at your CV the other day. And it's just like pages and pages of so much amazing things that you have done. So thank you so much for being here.
Jayson Davies 04:40
We're gonna get into that research in a bit. But I want to start off with some questions about how you got to where you are in the OT world and how you've made such a huge impact on the OT profession. And so my first question that I want to ask, and I do this with all my guests is, when and why and how did you decided to become an occupational therapist.
Susanne Smith Roley 05:03
Well, it was dumb luck to be on Really? Well, I didn't know what OT was really. But I was I was, you know, a college student. And my mom was a nurse. And I knew I wanted to work in healthcare. And I had volunteered in mental hospitals, and I wanted to do something in mental health, but I knew I did not want to be a nurse. That was great. It was way too messy.
Susanne Smith Roley 05:30
Funny, but then I looked in the catalog, and I was like, Oh, look at that. You can do crafts, and you can do mental health. And, you know, so I signed up, I got into PT School, which was amazing. And then, you know, and then I was like, Whoa, you know, what, what is this? What, what arewe really doing here? And I, but I think honestly, my confusion with what OT was was a contribution, when later I worked on the OT practice framework, I thought, well, students should come in and have a, you know, summary document that they sort of grasp this profession that is so profoundly important and has such a big impact on on our clients. But it's a little hard to wrap your head around. So you know, in that old English term occupation, what does it mean, you know, are you are you getting people back to work, you know, so, you know, that age old thing, you know, what is he? So yeah, I was, I was just lucky.
Jayson Davies 06:33
Wow. So yeah, it's always interesting, because, you know, you have people that knew they wanted to be an OT, because maybe they themselves or they had a sibling, though, that went to ot. But so often, you find that no one knew what OT was until they're basically in it. And that's pretty interesting. I had no idea about the practice framework, I actually kind of want to lean into that just a little bit. You You did work on the practice framework, but you kind of brought another side of it. And what you just said is that you really wanted to have this document for people coming in to really understand what the profession is. Can you discuss just a little bit about that? And your work with that?
Susanne Smith Roley 07:13
Yeah, yeah, I was, I was so privileged, I was invited to be on the Commission on practice for the American OT Association. And it was the, in the tenure, of their transition from uniform terminology to to something else. And that's something else ended up to be the OT practice framework, domain and process. So we actually stayed an extra year to get that first version done. And, and the idea was that the, the UT three had become like a shorthand even for, for billing, but it was it was a bit reductionistic. And so how do we take this volume of work in OT with so many different theories and methods and consolidate it into something that can be used for all given the diversity of practice. And so I think that was an enormous achievement. And then I was invited to chair the Commission on practice for the next term.
Susanne Smith Roley 08:18
And in that term, we were asked to revise it to do the second edition. So I was the first author on the second edition, of course, with a team, amazing, an amazing team, of teams and scholars. And, and, and in that position, we were also invited to then, you know, go in different parts of the world to share this with other leaders and other organizations. For example, in Israel, or, you know, where we went, we went to different places, Australia, and Hong Kong and and the leaders of those other countries.
Susanne Smith Roley 09:00
They didn't adopt our US model wholesale, but they use this framework to then construct their own, you know, with continuity of OT, and of course, then what we saw is that the OT practice framework then changed the curricula in all of the OT programs in the United States, so that there was conformity, consistency of language. And, yeah, so that was that was a huge and amazing undertaking, of course, now we have the third and fourth editions with other teams that have gone on, I think, to make it better and better.
Jayson Davies 09:38
Yeah, I mean, there was a great foundation, but man, I haven't even got through the fourth one. They really added a lot in this new version. I mean, it's a it's a handful, that's for sure. So I'm looking forward to getting into a little bit more. You just talked about having some very unique experiences traveling the world and I just want to ask you about that because one of my favorite parts of doing this podcast is that I do have people from China that reach out to me, people from Australia, from the UK, what has been a memorable moment for you, that has been a result of being an occupational therapist and sharing the profession.
Susanne Smith Roley 10:14
You know, I have so many memories, one of the things I was invited to do was to be on a panel in Brazil, with scholars there who were talking about the essence of OT and the impact of OT, and it was, it was really interesting for me, because there that most of the people on the panel were really theorists, you know, they were creating OT style theory. And I and I'm, I identify as a practitioner, okay, and I know, I've done educational research, but but I was like, well, let's get this grounded into practice. And it was really interesting to get feedback on that panel. I mean, I've, I've really traveled on every continent to teach sensory integration courses and, and meet with leaders, you know, and and, you know, really OT so magnificent in terms of the evolution of our profession, you know, the US we have, you know, we have the best textbooks that probably the majority, not that there's not wonderful textbooks emerging from other countries, but we have such a volume of scholarship emerging out of the United States that then influences people around the world. So in OT, in general, but then also in sensory integration. So we've, we've really gone everywhere and watched OT evolve in in various countries. And in my opinion, the work that we've done in sensory integration and the foundation of a scientifically fit theory, frame of reference with very scholarly data driven decision making that that informs clinical reasoning, it really advances the proportionality of occupational therapy in in other countries as well as the United States. Yeah, definitely. I mean, like you said, we just have a lot of the research that's happening here, OT I think it shows, it's more well known here than it is in several other places in the world. And so we have people in school, we have people doing doctor, we have people doing research, and that is that leads us to be able to have all that good stuff that we are able to do. Yeah, actually, again, going back to your CV, I saw that you had the W fit on your CV. And so I didn't know it's only like $36 a year, something like that. So I emailed AOTA I was like, boom, I want to be a part of that, because I want to know what's going on in the row. So, but Yeah, all right, well, you kind of started to mention SI a little bit, that's what we're really gonna dive into today. And as we transition into that, I want to let you just kind of share where you are at in your OT career, what's important to you right now, what are you focusing on?
Susanne Smith Roley 13:03
Well, you know, I'm, I'm on the downhill stretch here. I've been doing this for, you know, over 40 years. And, and, you know, what are we focused on, you know, the practical things I do on a day to day one is that I have my, my, you know, my private practice my business, and I conduct occupational therapy, evaluations and consultation. And, you know, it's housed in center point for children. And my daughter is now she has her doctorate in OT, and she's running that clinic. And then the other big piece is continuing with education and research. And we're running the nonprofit Collaborative for leadership in our sensory integration. We're offering synchronous and asynchronous online now, because of COVID. We're not doing any on site, but synchronous and asynchronous online education programs and sensory integration.
Jayson Davies 14:09
That's awesome. Yeah, I did have the chance to go through the WPS SI program back when it was with WPS. I know now, now, it's kind of gone a few different ways. And what you just mentioned is one of the ways and yeah, you were I think my course three instructor or one of the instructors, I want to say might have been you and Zoe but it was, it was just amazing being a part of that. And so I'm happy to have you here to share more about that. So let's talk about SI and that first question is, is how did you learn to count or how did you come to learn about sensory integration? And what were your kind of first initial thoughts of sensory integration? If you remember back when you're just kind of starting to learn about it?
Susanne Smith Roley 14:51
Well, it started in my undergrad. You know, I got a Bachelors of Science at Indiana University and one of my professors was Shereen Farber. And she invited us literally, the students to come to her house and study neuro beyond basic curriculum because we were all kind of stuck with, you know, anatomy and neuro and, and she brought it to life and she was working with joy house and I don't know if you know these names, but they were really they were they were producing seminal work and sensory motor functions in theory and also, you know, getting their toe wet in in research well and of course, it was about that same time that Dr. Ayres was publishing her original set of tests, the Southern California sensory integration test and, and she came to lecture and in some, some some place around there and I went to hear her and I was blown out of the water. OT in general, didn't captivate me, I was struggling with understanding what we were supposed to do. But as soon as I got into that I was I was captivated. And then I had the privilege to work with genius gardena in Cincinnati, I had a fieldwork, one of my fieldwork assignments was in the Cincinnati public schools. And so we learned sensory integration and from the bottom up, and it was just, well, it profoundly affected everything I have done to this day.
Jayson Davies 16:30
Wow. Yeah, you know, again, I hear your name, I see your name. And I just like to associate that with USC. But I know that you didn't start at USC. I know that came later and that you did work your way to Los Angeles then be a huge part of this community. How did that kind of come to be? How did you get kind of folded into the actual SI leadership and with the USC? And how did that come to be?
Susanne Smith Roley 16:56
Well, I turned right before I turned left. And so I was with an amazing group of students and you will know these leaders named Silas with you know, Shelley lane and Jane Kumar and Joan. And, and Mary Schneider and Charlotte Ryan, I mean, these are many people who have become quite well known leaders in occupational therapy and, and Jane, but we started teaching sensory integration, but I didn't have a master's degree. And I knew that that was critical. So Jane, Jane Kumar went to Boston. And I was thinking about Do I go to USC or to go to Boston University, and I ended up going to Boston University. And sure, sir, Mack, was, you know, my thesis advisor with Dan Henderson. So they were amazing. And then I knew I wanted to work with Dr. areas. And I heard her she was ill and, and I thought, well, I need to do this as soon as possible. So you know, given that you've already up ended your life. I moved to California to work with Dr. areas. And then I was captivated by the weather here. It was like, I'm not going back to those winters. Below windchill factor, right? I got seduced by the beach and the weather. And then also the work that was going on here, which was really quite phenomenal.
Jayson Davies 18:23
Yeah. And so let's continue on with that, then let's, let's talk about that work that you you came to USC, you're here. You're working with Dr. Dr. Ayres, a little bit. Tell us about that experience.
Susanne Smith Roley 18:34
Well, that was also life changing doctor's ears was one of the most thoughtful, brilliant minds. She cared deeply about the children and, and her insights and her inquiry was just unsurpassed. I mean, I have never encountered anything before or since. And I'm not the only one right
Jayson Davies 19:01
I heard that many times.
Susanne Smith Roley 19:04
Yeah. So I mean, she influenced a lot of people, she taught us how to think in in a scientific way. And then she taught us that to enact those principles, we had to do it in a very humane and compassionate playful way. So So this was really pretty phenomenal. And so yeah, I was, you know, I was able to, you know, anytime she spoke, I went in, you know, if I was like, you know, can I help you in any kind of way. So I was able to help her with some of the re standardization in a very small way. But, you know, but I kept hanging around and I would stay in touch with them. And, and so through that process, you know, I was around when the script was re standardized. And of course, I was one of the instructors for sensory integration international Until that closed,
Susanne Smith Roley 20:04
Things were going a little bit haywire there. And that's when we started the USC WPS program. Dr. Clark Florence Clark was the chair at USC OT department then and we pitched the proposal and I was the project director, then for that program for 15 years.
Jayson Davies 20:25
I had no idea that you're the program director.
Susanne Smith Roley 20:27
Yeah, I was the port. Well, for the sensory integration certificate program with that partnership between USC and WPS. I left that position a little bit before they dissolve the partnership, they dissolve the partnership in 2016. And that's the point at which USC stopped teaching this except. We started our programming class here in 2017. We felt that, you know, we didn't know that they were going to create another program. USC has since started teaching sensory integration classes again, but so in 2017, we continue to we continue to teach the SIPT. I know there's some misinformation that once they dissolve the partnership, the script isn't valid anymore. That's that's not real. But yeah, we continue.
Jayson Davies 21:24
Yeah, continue doing it. Well, so I don't want to jump too far ahead of myself, I want to ask you more about the class that you worry about the easy all that good stuff. But I want to kind of stay where we're at right now. The SIPT, you mentioned that, as far as I know, right now, the script is still the quote unquote, gold standard and sensory integration, Is that still the case right now?
Susanne Smith Roley 21:52
That is still the case right now. The SIPT is quite an amazing set of 17 tests. And it's the only collection of tests that I know, that allows you to understand the complexity of sensory motor and praxis abilities in children. And it shows you the different patterns, the way children are processing and integrating information. And, and it also gives you a roadmap of how to do intervention. And I don't know any other tests that allow you to do that. It's a it's a performance measure, and you have you get standardized results. So it's quite phenomenal, actually, as as a tool.
Jayson Davies 22:41
Yeah. And I remember I set like I said, about six years ago, I think it was the district that I was working for, they wanted someone that has some SI training. And so they sent me to all four of the WPS USC courses and si.
Jayson Davies 22:55
Again, like I said earlier, I think of the third course that you were there. And I just remember being able to, like something would just pop up on the screen. And you know, you know very well, it's the bar chart, the bar chart has 17 different tests and black lines going in every which direction, and the fact that you could just look at it, and kind of almost give a story about this child based upon this chart. And I'm struggling, because I don't even know how to how to ask you this question. But what what does that look like? What goes through your mind as you're looking at the child's sensory integration practice test report? What are you seen? Some of us who aren't as well versed? I don't see.
Susanne Smith Roley 23:41
You know, actually thank you for bringing that up. Because I remember when I was working with Dr. Aaron's, she did that she held up a graph. And she, and then she just narrated what was going on with the child. And then she said, Well, in this and then Susanne, you should take this child, and you should get on the bolster swing, and they should swing and prone. Okay, how did how did you get there from there? And then she could also see when there was an error, you know, while this you know, this is probably measurement error by the on the part of the therapist, I mean, she could see when, when things weren't scored correctly. Well, now I've tested I mean, literally over 1000 children, I mean, you know, I do a lot of tests. So now what, okay, so a couple of things informs our information. One is, you know, having a lot of experience with a set of tests, but the other thing is that we have so many factor analyses that have shown us the relationships between the tests, so So when you're looking at the configuration of schoolers, it almost gives you a profile of the child's nervous system. So you know, if they have Language based concern if they have visual perceptual concerns, just the visual perceptual system work well, but they still have visual motor concerns, or do they have poor body awareness through the tactile or proprioceptive systems, then you start looking for praxis or dyspraxia, because you know, that's a pattern, and then you can see the vestibular piece. So, so you start to assess the strengths and weaknesses in the different sensory areas, and how that links to those sensory motor skill areas that then are most related.
Jayson Davies 25:39
Yeah,
Susanne Smith Roley 25:39
And then that allows you to understand, you know, what's going on, you know, in a certain kind of way. And then also, you know, where, what are they going to like, and they're not going to, like, they're not going to like, what's hard for them, they're not gonna, you know, if their language system isn't working for them, they're not going to like to follow a lot of verbal directions. You know, if they're just praxic, their transitions are going to be hard for them, they're not going to like other people to figure out something and have them do it, because they're not going to figure that out. If they can't imitate, they're not going to like modeling, because that's going to be hard for them to decode. So it so it helps you understand behaviors that sometimes are interpreted in another way, or not easily understood.
Jayson Davies 26:29
I Like the way you phrased that, that are interpreted in a different way are not easily understood with behaviors. Because so often, especially in the schools, you know, I'm a school based occupational therapist, we often get dragged into see a student and the referral is behaviors. And sometimes the student will have a BA, sometimes the students will have a functional behavior assessment with a behavior plan, but they still ask the OT to come in and look at these behaviors for sensory reasons, or whatever that might be. And so I actually want to kind of go a little bit further with that, and tell me more about those behaviors and how sensory integration can or difficulties with sensory integration and affect behavior.
Susanne Smith Roley 27:16
Yeah, and I think that that's interesting. And, you know, we're very committed to assessment. And so I think it's, it's one thing to see on the surface of what the children are doing. And you know, you and I know that you're going to see a whole range of behaviors. I mean, you know, depends on the system. So do you have a child with attention issues that can't sit still in the chair, and they're popping up and down, and they're not getting their work done? And they're very capable, but they're not sitting still? Why are they sitting still? So when is that? Is that just a DD or ADHD? Or maybe do they have a vestibular problem where they're not processing movement and sustaining a stable posture? Could that be a hypothesis, of course, you have to do the assessment, and you have to figure it out, because it may be just ADHD, that's a, you know, biochemical issue that, you know, is going to respond to Ritalin. And that's, you know, it's not, it's not, the foundation isn't sensory. Right? So that's fully possible. What's happening a lot now with so many kids on the autism spectrum, is that there's a whole range of behaviors where there may be, you know, self-injurious behaviors or, or running into their children or somehow pounding their body or throwing themselves on the ground. I mean, so so more of a, you know, getting their body involved too much too vigorously, where they might hurt themselves or others and really rejecting what other people want them to do. And so, for those children, you know, what I would start to assess in the line of tactile awareness, kinesthetic awareness, and praxis do they do they know? Can they perceptually interpret what somebody else is thinking that the other person's plan? And then, you know, even if they understand the goal, do they know how to get there? Do they know how to make that happen that and so many of those kids with autism have that and then such extreme responses to sensation. So it's either very under or over response. So sound hurts, some aspects of touch hurt, you know, food, you know, if they hear the, you know, the pipes or I heard one example that just blew me away. It was a it was an adult with autism and he was explaining when he was a student that he took a spelling test. And when he finished this test, he had 40 words, that there were only 20 words on the test. And the teacher discovered that he had written the words that the adjacent teacher in another room was giving to her class, as well as his own. And so you think, well, what is going on with that auditory system? And of course, this man would get completely dysregulated by the end of the day, or if there was too much sound because he couldn't, he couldn't inhibit, yeah, all of that. And then, you know, keep decoding, the decoding was putting such a load on his nervous system, that he was just completely fatigued. In social environments.
Jayson Davies 30:50
Yeah. And, you know, that's really why I wanted to come on here, I wish we could go over, you know, I wish I could just show you a video of a kid and you do exactly what you just did. Obviously, that's not the time or place for that we're gonna we're talking about sensory integration. But that's really what a course is for. And you know what, we're gonna save it till the end. But I'm going to, to announce, you know, Dr. Roley, has been so kind to actually give us a discount for OT school House listeners. And so we will talk about that. That course in a minute. I want to ask you, for those of everyone out there, there's, there's a lot of people that aren't trained formally, in the CIP aren't trained formally, through CLASI, or through any of the sensory integration programs. What do you what do you and I'm sure you get this question a lot. What do you say to school based OTs or even clinic based OTs that say, you know what, I just don't have that training. What can I do? What do you recommend?
Susanne Smith Roley 31:43
Yeah, you know, our entry level, OT preparation is phenomenal. There's so much that that is given to us in it at an entry level. But one of the things that I did when I was the chair of the sensory integration special interest section, was to survey all of the programs in the United States. And I did it of course, with my committee, none of this I did by myself. But we surveyed everyone and we said, how much information do you get on sensory integration? And it was somewhere between none. And maybe a week or two weeks, but that, you know, generally, it was like, a couple hours, and it was usually embedded in a pedes course. We did it again. Okay. And I think that this was when Theresa May Benson was the chair. So So again, we surveyed say, Okay, well, what's going on, it was very similar results. So what we know is that these specialty areas, not just sensory integration, but other kind of specialty styles of practice are not covered in the general curriculum, and so on. So this is, I think, something to be aware of that, that you need postgraduate training, if you're going to specialize in sensory integration. There are, it's not just CLASI, there are other programs. As I mentioned, USC has a program. Teresa May Benson headed up a program through the spiral Foundation, I think she's now doing education courses privately. There's, you know, other programs around the world doing it through the South African Institute of sensory integration, asi wise, in the UK, Austria. There, there are other programs, not just ours, but I would very much encourage people to meet the international standard, the international council for education in sensory integration have a set of guidelines, we published an article on this and OT practice, I'm happy to share that with you, if you want to share it with your, your, your listeners, yeah, to to move from entry, you know, or basic level understanding to a certificate, and then of course, on to more advanced and expert levels. So So when when I'm sitting across an IEP with a with a therapist, who doesn't have this training, and then it's a little harder to, to have that understanding of what the what the assessment data shows, and, and sometimes there's not always agreement on on what to do about it. So that's, you know, that's always
Susanne Smith Roley 34:37
Where would you Where would you recommend that someone start if they say, Hey, you know what, I want to learn more about sensor integration, maybe they're, maybe they're a year out of school, maybe they're five years out of school and they just say, Hey, you know what, I want to learn more about SSI should they start so they just say, Hey, I'm going to go through all four or all six however many classes there are and just pick a program and go or you kind of mentioned in the article that You're just talking about, but what would you What's that first, first two or three steps that they should start doing? Well, you know, the the book that I love that I think everybody should start with is sensory integration in the child by Dr. Ayres. And you know, right now, we did a remake of that so that it's updated. It's published by Western psychological service. So sensory integration and child is, you know, that's, that's the beginning. And then, you know, the most recent book textbook is Schaffer, Mailloux 2015, a clinicians guide to using sensory integration with autism, it's based on shock at all, randomized clinical trial, it's a manualized, err, sensory integration, it's beautifully organized. And then in terms of courses, I would say, you know, to start with a theory course, you know, sensory integration theory, I, you know, made the one for CLASI, but you know, there's others that you, you know, I mentioned other programs, so that, I think, go look at sensory integration theory and, and start to get a good understanding of that. Because I think the more depths, you have an understanding going into it, the more motivated you will be to continue.
Jayson Davies 36:21
I agree. And I mean, I'm SIPT trained. Technically, I'm SIPT trained, I don't use the SIPT very often as a school. So I just don't, but the theory, the theory is invaluable. I mean, it is just something that I think every clinician, if you're going to be working in a pediatric setting, you need to at least have the theory. So that way, as you're looking at a kid, as you're coming up with different ideas, at least, you know, the theory behind it. And so it's an option. So yeah, I agree with that. All right, so let's jump into the CLASI and the easy a little bit. Just share with us an overview of what is CLASI versus what is easy. And yeah, just an overview of what that is.
Susanne Smith Roley 37:02
All right, well CLASI, as I mentioned, is our nonprofit. And, and we're, we formulated it so that we would have an organization that where we could offer educational opportunities, but also seed leadership. So we we know, were aging out of, you know, being the people who are teaching and you know, and of course, many of our mentors are, are retired or retiring. And so, so our idea was to get a foundation and to cede leadership around the world. And you know, that's really happening. We have, we have really amazing people all over and across the country and also in the United States. And, you know, Dr. Kelly, all dried, who's working with us say that, you know, and just to name one, I mean, everybody.
Susanne Smith Roley 37:54
Okay, so that, so that was so CLASI, we've tried to get together. materials, we have a training program that has now been offered all over there, I think we're in 20 countries, maybe, maybe more. And when we're collaborating with at least 10 other international organizations, and there's the pandemic sort of slowed things down. But there's a lot of international interest. Now, the fact that we've been able to sustain the work of CLASI through virtual media has been amazing. And we're trying to get a lot of work out that that people don't have to spend a lot of money and that we can get resources. So one of the things that we had so much fun putting together was our wind down Wednesday webinars, and
Jayson Davies 38:52
I did do a few of those.
Susanne Smith Roley 38:53
Yeah, yeah, yeah. So we, you know, during the pandemic, we said, okay, how do we stay connected, and this whole idea of social distancing was like, okay, physical distancing, distancing, but socially connected. So we were able to make those available, you know, at no, no charge. So we're trying to get more resources that, you know, don't cost too much that are that are going to be available to, to therapists and, you know, to, to get as many resources in the hands of families and, you know, one of the goals is children understood. Okay, so this, this is our tagline for assessment. I'm Zoe Mailoux, who's my partner with CLASI and of course, we have Katie Estrada. I mean, there's other like, I, I don't want to leave anybody out. But if I start naming names, I'm gonna for sure leave people out. And Zoe was, was Dr. Ayres’ research assistant when she was being on the sipped. And so she was and then she ran the ears clinic for Many years. And so it's such a powerhouse, brilliant therapist, and so together with Dr. Diane Parham, who, who, you, she's so wonderful. And yeah, so she she's been very instrumental in assessment development, including the sensory processing measure, which is very well, widely used now. So the three of us, we felt that we understood the limitations of the sift, mostly accessibility. And I don't need to go over all of that, you know, you you don't use a soft mention, you know, why, okay, because, you know, it's a big heavy button. So, we, we thought, but here's the problem is, if we don't identify the problem, the problem will not be adequately addressed. And one of the dilemmas is that most of our materials are in English, you know, so, so that privilege we have in the United States of having so many resources, we kind of started out that idea of like, Oh, we have so many textbooks while they're in English. So how do we get this in the hands of people all over the world, and not just in our, you know, US language, and also not just us centric normative data so.
Susanne Smith Roley 41:24
So we develop the easy set of tests. They're a set of 20 tests. And they're designed to assess all of the constructs of the of sensory integration and praxis. So including the perceptual areas, the postural and motor areas, and the Praxis areas and reactivity. So these are 20 performance test. We field tested them, we've pilot tested them, they have high, each item has high discriminative validity and reliability and then we started collecting normative data all over the world. And we, you know, our goal was 100 countries. And I think we had over 100 countries signed, that, then the pandemic reallyput a wrinkle in our plans, and slowed everything down. And we still would like to collect more normative data. But right now what we have is we have about, I want to say 2400, sets, data sets, that's a lot. It's a lot. It's, it's worldwide. And I think we have it translated in maybe 10 languages. And so the process that we're in right now is to see, could we generate some preliminary normative data through these, these datasets once? Once that's done, which, which we're predicting is in 2021, we're working with an amazing team of experts, including Anita Bundy and her associates. So yeah, so that's, that's what's next, once we have the normative data, we can start to use the test that and we've tried to make it easily accessible. So at a very affordable price, just for the cost of the materials, and then there will be some costs for maintaining the website. But other than that, this is, you know, really a truly a nonprofit venture and CLASI has agreed to, to be to house this project, you know, so. So yeah, if we can have an affordable, accessible set of tools, we hope that more therapists will be willing and able to use these tools to, to identify and then get the right intervention going.
Jayson Davies 43:58
Yeah. And so for anyone I know, we're using acronyms, and just for everyone out there, easy stands for evaluation in Ayres sensory integration, right? Yes, yes, yes. All right. Okay, so you mentioned 20 separate tests for the easy earlier for the SIPT is 17. And I know you guys really looked at the CIP when developing the EZ, you really wanted to kind of I know you didn't want to redo the CIP, but you wanted to redo the CIP in a way? So, Are there additional tests are Why is it 20 instead of 17? And why did you decide to do that?
Susanne Smith Roley 44:35
Well, we did use the SIPT. It's a brilliant set of tests. And so yeah, so we looked at that original work that Dr. Ayres did in the early to mid, you know, 1980s and, and that informs our constructs, and so all of the research that was done using that tool, all the many, many, many factor analyses that were published, so so We used the script as a model of beginning. And it defined the constructs. So, so where did we get 20 instead of 17? Well, you know, some some of our tests that we had hoped to do like a driving test, like the Berry motor coordination test, or the motor accuracy test, we, we weren't able to obtain, you know, discriminative data. So we don't have one like that. But But we do have the beer and we have the motor accuracy test. But we have all of the constructs covered. So we have in the perceptual area, we have tests of visual perception and tactile perception of proprioception force and direction and vestibular related measures. And in the area of reactivity, we have one reactivity test where we're actually doing, you know, sensory things and seeing does the child like it or not. And then we also have observations of reactivity during the tactile and movement tests. We also have auditory localization, that's new, doctors didn't have an auditory localization test, we have the postural control, areas of testing that we used to do just clinical observations, but they were they were not standardized. We took the ones that we had the most confidence in that we're the most reliable, that discriminated and we have a postural control measure. We also have balanced and bilateral coordination. And then praxis we have
Jayson Davies 46:44
everyone knows the blocks, everybody, everybody has seen that structure.
Susanne Smith Roley 46:50
Yeah, yeah, yeah, well, now we have make a silly room. So we have something something a little different, I mean, such so exciting. And then we've added an ideation measure. So So that's an additional measure, you know, errs, didn't finish an ideation measure, the only thing we have in the tactel area, which is so cool, that we've added is an oral practice test. You know, so this has huge ramifications. And we have an ocular motor practice, test. So So we've added components that are supported by research that are with items that are reliable, and valid. So So yeah, we've been able to expand a little bit from what the model was with the CIP.
Jayson Davies 47:40
Awesome.
Susanne Smith Roley 47:41
And also, it's more modernized, right? So we, we are using rush analysis, where we hope to have a start and an end point, that will shorten the length of the test. It'll be online, you know, so the examiner could, theoretically, put the answers in as you go. Now, some of this you're going to have to learn how to score for example, ideation. You have to video now, I mean, I do I mean, count and, and score. So so it won't be automatic, but you will, you know, it'll be much more in real time with with modern, you know, more modern statistical tools. And, and what we hope is that it will make it more efficient, and easier, shorter.
Jayson Davies 48:31
Yeah, that's great. I did get asked to do the CIP. About a year and a half ago, I had, first of all, I had to find the little USB key to plug into a computer, then I had to find a computer that was old enough to run the program. So that'll be great. That'll be easier to get access to and whatnot.
Jayson Davies 48:50
You know, one thing that I do want to, we're gonna go on, we have one more real topic that we want to talk about today. And that is kind of your practice, where you do evaluations, um, you mentioned it slightly earlier. But I want to dive a little bit deeper into that. But first I mentioned I meant to talk about this earlier was to congratulate you and everyone who has had their hand in SI, on it now being recognized as an evidence-based intervention for children, youth and young adults, by the National Clearinghouse on autism evidence and practice. I want to get your thoughts how meaningful is that to you? I know there's long been a barrier. It's always SI doesn't have enough research. SI doesn't have enough research. That's what a lot of people would say. When when SI was brought up. So how important is this to you that it is now considered an an EBP evidence-based intervention starting in intervention?
Susanne Smith Roley 49:38
Yeah, yeah. And, you know, it's it's so exciting to see what's going on right now. But I will tell you that when I started learning, sensory integration in the 1970s, it was the only evidence-based practice I was learning. So sensory integration has always been evidence based. However, one of the things that happened is As OT the mandate became that you had to be evidence based. SI was there to critique, right? So many of the things, many of the methods that we were using didn't have evidence to critique an SI did and the state of SI research in terms of, you know, the rigor, I think also paralleled the maturation of the field, the profession of occupational therapy, we weren't, we weren't sitting at the table, getting those big grants with an NIH. And we have the biggest, best brightest minds submitting grants, and we were not able to play. Nobody got nobody was getting funded, because they were not sitting at the table. Distributing the grant. So so so yes, I know the rhetoric of SI doesn't have enough research, but it it OT doesn't have enough research. And so SI kind of paralleled that. But, but I was very privileged to be part of the SI research collaborative that started in early 2000s. And this was a collection of universe diversity based researchers and practitioners that came together with the small planning grant. And this, this, this little team that we have about 10 people have have continued for over the last about 20 years, and we've done a lot. So with a very intense intent to build and support the research in sensory integration, we've managed to publish a couple of special issues of HR, I think, maybe three special issues. We've done a lot of, you know, publications, and one and one of the most recent and influential is the Shown et al. systematic review in 2018. So, so this systematic review went into the Journal of autism, and it's got a very high impact factors. So that means it has you know, more influence. And so this was huge, because, you know, there's there's also a press from the outside, not just from the inside to diminish sensory integration in lieu of methods that are, you know, maybe more near and dear to the heart of other professions, because Si, in my opinion, belongs in OT, its best development it developed in OT so. So this was huge.
Susanne Smith Roley 52:36
And then that external review, I think you're referring to the Frank Porter Graham report on on evidence based methods in autism, and none of none of us that I know was was involved in that. So that was completely external. And they included sensory integration as an evidence based method. Now this is because primarily because we have two very strong randomized clinical trials, one by Schaaf, and all one by Pfeiffer at all. There's also another article by Dunbar now these are not the only intervention studies in sensory integration, we have many more, but these were the strongest randomized clinical trials. So we have met the external criteria. What is enough? I mean, how much you have to have to say you're evidence based and we've met met the threshold.
Jayson Davies 53:28
Yeah, that's awesome. I just think it's amazing because throughout OT school, and my younger years, it was constantly people like saying, you know, SI doesn't have the research. Si, oh, it's just a, it's just a one kid, you know, study. And now, like you said, there is that that? Well, it's always been there. But now it's really ingrained. It's a really strong to research articles that you really talked about there. So perfect. I really appreciate you saying that, that I think that helps a lot of people out there who struggle with it, you know, I want to provide Si, but I get that constant push of people saying it doesn't matter. It's not. It's not real or doesn't exist, or there's not enough research? Well, no, there is research, so great.
Susanne Smith Roley 54:09
Well, and that I will say Okay, so what also came out very loud and clear, especially in the eo ta 2018 review was when you compare the intervention studies, not just to randomized clinical trials, but the the wealth of studies, the studies that used a technique on its own, for example, a weighted vest or a chew toy or sitting move question. Those studies show very little evidence that they work at all okay, now that could be because maybe the studies are very strong, but there's no evidence that says doing a sensory accommodation is evidence based. Okay? So this is really important for school based therapists because then when you compare to err sensory integration, which is used with fidelity, the manualized you know, where You have a space to work, you have equipment to work with where you're doing the individualized therapy based on the characterization of the problem where you've done a complete assessment, that is the kind of the intervention that is evidence based. And so you can't say you're doing an evidence based intervention if you're just using a sensory tool. And so this is also really important, because, you know, the rhetoric for sensory to go, you don't have enough evidence. Well, now we do have enough evidence. But then there's a pushback of using a manualized intervention thing. No, we have enough. We have the evidence, it works. But you got to do it. Right.
Jayson Davies 55:42
Yeah. And I know you and the whole team spent a lot of time developing the fidelity measure and making sure that it was separated between what is sensory integration, versus what is might be sensory strategies or something else. And so yeah, no, I think you're right about that, too, is that we can't confuse articles that aren't sensory integration with sensory integration. Yeah. All right. Well, let's jump to our final segment that I want to talk about, and that is IEE's independent educational evaluations. I know you provide independent evaluations down here in Southern California. And you know, at school based OTS, not all but but many of us have felt that pressure of finding out that a parent has requested an IEE. And, you know, sometimes it can cause some anxiety, or it makes us feel like maybe we're not doing everything from the outside provider perspective, because I know you do those iees. What do you interpret when a parent comes to you or whoever it is that comes to you, the district advocate, whoever might be asking for an IEP? How do you interpret that record that request?
Susanne Smith Roley 56:46
Well, okay, yeah, that's, that's the majority of my private practice right now. And I've been doing it for many, many years, since since the IDA reauthorization, gave parents the authority to request an outside assessment, you know, from an objective party that was not part of the district. And, and, you know, I am very happy that that parents have that opportunity, because it does give an environmental press right, it, I think it ensures accountability. And the other thing that I've seen in the best possible scenarios is that the team is informed by experts coming in, almost like consultants, and informing the team in their area of expertise. So I think that's when it's working the best. Now, you know, I know that sometimes it feels adversarial, and, and in my, I really wish that it wasn't like that, I wish that I really, truly wish I can play guitar. I like where you're going with the whole, it should be more consultative in nature in a way and working together. Yeah. So. So again, you know, as a as an evaluator, I think my job when I'm being asked to do is to take a snapshot of the child in a certain amount of time to see what's going on before, how is the child situated is its educational program, and at the end of the day, is it going to be beneficial to serve as a related service to support that child in his educational program? And is it educationally necessary, right, that's, that's the mandate, legal mandate. And so for me, what I need to do is I need to look at the assessment data, I do my own assessment data, I gather information for the teachers, the parents, we observe, we, you know, do performance assessment, and then we come up with our conclusion and our recommendation for service. And sometimes it's in, in conflict with what perhaps the district therapist has, has recommended, and sometimes it's very consistent with what the district therapist has recommended. And in that case, it's the best possible scenario that we're refining the goals, you know, we're in agreement, okay, maybe we're 15 minutes, you know, a week difference or something. But sometimes I have to say that I do an IE, and I can't even imagine that the child that I have seen has not been recommended for OT service. And so in that case, and I'm I'm very much an advocate for this, for the student to get what they need.
Jayson Davies 59:42
Yeah, and I think that's totally appropriate. And I want to ask you a little bit further is within your evaluation, how, what tools do you use, whether it be citing evidence, or really the experience that you have? I don't know. But what tools Do you use to really bolster your evaluation to give it the weight that? Yes, this is a real good evaluation? Does that make sense?
Susanne Smith Roley 1:00:09
Yes or no. And I'm glad you asked that as well, because sometimes I think I have sensory tattooed on my forehead. Reality is that I'm very informed by the OT practice framework that I work that I have done. And so I tried to get the full spectrum of the OT process engaged, you know, so starting with occupational occupation, and ending with occupation. And so I, I use an occupational profile, I use sensory motor assessments, if I can, I can always use the SIP, sometimes it's not possible, but I try to get sensory motor, I try to look at those foundation abilities. And I look at adaptive skill areas. So I want to see you know, what's actually going on in the daily life routines, many times from parent and teacher report, I want to look at skills, the fine motor skills. So I'll also do something like the theory or the test of handwriting. So you know, I want to see real skill. And then I also look at higher order functions, such as using the brief, so I try to hit the the range of, you know, of developmental sensory, motor adaptive occupation, skill ability, and try to get into those performance patterns, as well. So when I, when I make my recommendation, I try to make it with that whole scope of function in mind.
Jayson Davies 1:01:42
Yeah, no, and that's great. That is not just sensory, if you are taking it from an occupation base from the top down approach to get everything. You said that in the best case scenario, you and the districts are kind of on the same page, when that happens? Do you call it a day after that IEP? or do some districts? Have you kind of maintain a consultative relationship at all? Or how does that work?
Susanne Smith Roley 1:02:10
Well, okay, so usually, my job is done. After I attend the IEP, I sometimes I will collaborate with the OT outside of the IEP to try to refine the goals or get together with that secondary IEP to make sure that that's, but in terms of actually providing a service to the family, following the IE, I don't do that. And that's to prevent conflict of interest. It's so you know, I, I try really hard not to have a have a pony in that race, where I would benefit from ongoing consultation with a certain district or a family. I just don't do that. But I really do try to get the family and the district connected with service providers in their areas. So we're always looking for, you know, OTs that that might be looking for a job in the district, or maybe they have a practice in the in the area, you know, something in proximity, because families come from all over. So try to try to get them connected with resources.
Jayson Davies 1:03:19
Awesome. And, you know, one thing I want to get out of you, because you mentioned this when we were talking in our phone call that we did the other day, and that was that you sometimes see both influxes and drops in IE is from particular areas. What do you make of that?
Susanne Smith Roley 1:03:41
You know, that just happened today, I got two referrals from a district that doesn't usually call me so I think, all right, they've got an advocate in there who's decided that they that they should use me or maybe they got on a listserv or, you know, parent group or something. But But oh, but over time, what seems to happen is that the districts who are who are functioning very well, and the and the parents are happy, they don't call they don't contact me, you know that so, so I don't get to see all the good work that you guys are doing out there. I mean, that's not who comes to me, you know, if they're happy, I don't hear from you. But, but then what will happen is that, you know, maybe they're going along this happened with one district, I won't name it, but things are going so well there. And then suddenly, I got 1-2-3. I had like, a half a dozen referrals and you go, Well, what happened, you know, and then you go, Okay, well, you know, what's going on in that district, you know, and so I don't I don't always know as an outside evaluator what happened but many times what happens is either the administration has changed or they have changed the rules or suddenly, some administrators decided they're going to take a hard line and they're not or They've started taking services away from children. And then I, and then I get a whole raft of them. And then I know like, okay, what's going on, and hopefully that situation gets repaired.
Susanne Smith Roley 1:05:15
Or sometimes there's an underserved district, and suddenly somebody who's in there who's kind of better informed, and they're going but wait a minute, we don't get those services. And so this is this is something you know, being from, from more of the coastal communities, you know, they, they get lawyered up real quick. And those families, you know, get services pretty quickly, and then you go a little inland to underserved communities, and sometimes you just, you know, it's really hard to believe what they're not getting, you know, they're like, well, if you were in my area, this is what you would be getting more automatically. So sometimes, they like, Oh, well, if, and then then families get on board, and then they go, Okay, well, we, we want that too. And we want that too. So sometimes it's a bit of a snowball effect. But one thing I want to, I want to say is that, you know, when I, when I started here in Orange County, I had already worked for a public school in Ohio. And it wasn't just for children with orthopedic handicap, or severe mental illness or, you know, severely involved kids and, and there was nobody in Orange County, there were no OTs being employed in the district. In fact, CCS all the special ed kids, they didn't get CCS, they didn't get anything. Yeah. And one by one by one vote, we advocated we advocated hard because the districts didn't want to contract out to, you know, a private agency or an NPA, one by one by one. And I will have to say, you know that, oh, that most of the districts now in, in Orange County and surrounding counties have OT, but more. And so I continue to advocate, you know that, you know, that, that you have this, and now you have an I know you guys have these big cases, but you know, you so you're not Yes, so you all those kids need OT, you need more OTS. And not only do you need more OTS, but you need a space to work, you need your equipment, you need reasonable size caseload, and you need the time to assess and make the proper intervention because otherwise the parties feel completely overwhelmed by just the magnitude of demand that that's coming at you and and so that, you know, that's hard, but that can't dictate what you recommend for an individual child.
Jayson Davies 1:07:48
I'm so glad you said that, because that's the same thing. I say the same thing. You know, we oftentimes as OTS, and whether you're in a school or outside of the school, you we complain about our caseload? And then what do we do about it? Oftentimes, we'll try and exit kids? Well, that's a different way to go. A different way to think about that is to say, Well, I need help not to exit kids, but to say I need help. Look at this growing caseload, it's growing year after year after year. And that's not the time to say hey, let's exit kids because I have too many kids. No, that's the time to ask for help. Go to your administrator and show them how you can't fit. I don't know, I'm just gonna make up a number of 500 minutes in a week, when there's only 400 minutes. Like that's just how it is you need me to say help. So I'm glad you said that. And we need to advocate for other things too, like a space
Susanne Smith Roley 1:08:34
Yeah and you need to advocate. Yeah, I mean, I was in an IEP team meeting where the OTC Well, I couldn't I you know, I use the psychologists’ room when they're out and I can use the hallway and I went around the room, it's like speech. Do you have a place to work? Yes. A PE, do you have a place to work? Yes. Psychologists? Yes. Teacher? Yes, OT was the only one at the table who did not have a place to work? We, I mean, this. This is a point of advocacy. We need the tools of our trade and access to the tools of our trade and then have reasonable caseload I mean, that's all advocacy at it at a at a local, state and national level to ensure that the services that we're providing are effective, and I'm not just talking about SSI, but you know that I was in an IEP, recently where the child was given five minutes a month about tea. And I know people are asking me about the effectiveness of SI but I want to know what is the effectiveness of five minutes a month, consult protein, what can you Oh, well, my my child got it, but it didn't work. That it doesn't work. It doesn't work to have such a minimum amount of service that that it renders the perception of OTs ineffective when in fact, you guys haven't been given an adequate amount of resources to to make a difference. The other thing is just to have handwriting goals and not expand. I was in an IEP meeting where they said, well, OTs don't work on mental health. And I was like, Oh, my goodness. Yeah, yeah, actually, we do, we have a huge history in our profession, of mental health, we are such a valuable resource in that direction of mental health for so many of our students and so, so also, I advocate not to be reductionistic, in the role that OT can play in school based practice is not to overwhelm the practitioner, but but to have more of a breadth of understanding also, somebody told me over the child's 13 and, and you know, he's a little too old for OT, and our adolescence, this is a huge area of advocacy, because our adolescents are, are getting depressed, they're overwhelmed. They're transitioning to a whole other level of demand in their educational process. And 13. You know, when you're my age 13 still looks like a baby.
Jayson Davies 1:11:14
Oh, man. Yeah, no, you're right, though, and I am getting it. I mean, I'm all I'm on social media, I had the podcast and people have been reaching out, a lot of people have been reaching out about what to do with high school what to do with adult transition. And it is absolutely the right place for Occupational Therapy. I'm not saying it's easy, but it is the place where there is a need for more of us to find out more information to be more supportive in that role.
Susanne Smith Roley 1:11:41
Yeah, because we're all about promoting health and participation through occupation. I mean, using lifestyle design and redesign. And, yeah, so those high school kids, you know, yeah, there's, there's the need is, is vast. But you know, okay, so I don't I don't want to leave on this note of grievances. But I just think it's so amazing to see that schools are, you know, one of the biggest employers of occupational therapists in the United States, it's, it's phenomenal to see the impact we have had, as a profession, in schools, when, you know, like we started, people didn't know what OT does. And so clearly, OT has something to offer. That's, that's unique and really valuable. And it's so amazing. I mean, it's so great for me to see that that possibility exists, where it didn't exist for, you know, people in my family, my brothers who had have disabilities, and they didn't get any help, no help. And you know, he's there for these kids. So, you know, that's, that's so amazing.
Jayson Davies 1:12:59
Yeah. And I think it's now it's about one in four, one in five occupational therapists work in the schools. And like you said, Yeah, they're just continuing to grow. I mean, there's more and more OTs in schools every day. It's fantastic. And we just got to, we got to keep advocating for ourselves and make it continue to happen. But, Dr. Roley, it has been a pleasure to have you on thank you so much for coming on, and being able or allowing me to pick your brain a little bit on sensory schools on IE, is there anything else you'd like to say before we wrap up?
Susanne Smith Roley 1:13:33
You know, I just think that we're pretty blessed to have such an amazing profession. And I have had just the best career ever. So just good luck to everybody who's listening. It's, you know, I think it's just great in any way. Thank you for what you're doing and your contributions. You know, this is this is pretty awesome. What you're, what you're contributing out there. So thank you to everyone. Thank you. And then lastly, can you just really quickly off the top of your head, give the website for the CLASI? I can't remember what it is. Yeah, it's cl-asi.org, cl-asi.org.
Jayson Davies 1:14:21
Great. And I will be sure to put up the link to that as well in the show notes, as well as the discount that Dr. Roley and the CLASI team are offering to listeners of this podcast. It's for about a month so you have access to it. Until I think it's about the middle of March of 2021. I know you can listen to this podcast well beyond that, but there is an end date for that promo. And so be sure to check that out soon. And if nothing else, take the class the first class which is the theory class right?
Susanne Smith Roley 1:14:57
Take all of them! They're all really good.
Jayson Davies 1:15:00
All righty. Well, thank you so much. And we'll see you later. Take care.
Susanne Smith Roley 1:15:04
Thank you. Bye bye
Jayson Davies 1:15:05
Bye bye. Alright, so thank you, everyone, and a huge special thank you to Dr. Susanne Smith, Roley for coming on here. Please do check out the show notes at OT schoolhouse comm forward slash Episode 63 where you can get all the resources that we talked about today, or at least a link to them, as well as the transcript of the show notes in case you'd like to read along or review it at a later time. All right, so again, take care. Have a great day. Hope to see you at the back to school conference in August. Bye bye.
Amazing Narrator 1:15:35
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