The STUDENT OCCUPATIONAL TIME LINE (SOTL) ^TM provides both a text and visual overview of daily student-on-task school performance. It forms a foundation for discerning personal, contextual, and temporal events that may contribute to dysfunctional behaviors of those students with Asperger’s syndrome, autism, or sensory processing and modulation disorders.

The tool is designed for professionals who work with children in school settings ranging from early childhood or preschool programs through high school levels. It is easy to use; a paper and pencil checklist combines with Internet data entry. Two new additions are being developed: one to support clinicians in scrutinizing a child’s performance on an hourly basis and to the other to facilitate parent’s and clinician’s consideration of the effectiveness or generalization of therapy in home and community settings.

The SOTL process is a two-stage process:

1. Therapists, teachers, and/or para-professionals compile data over the course of a day for a student or students using short or long printed forms (the SOTL Day Logs).
2. Therapists enter the data in the SOTL database using the corresponding section (short form or long form) of the Internet program.

The results are then viewable in one of two ways:

1. The SOTL worksheet: color view.
   

   Worksheet Color View Click on picture to see larger image

2. The SOTL worksheet: text view.
   

   Worksheet Text View Click on picture to see larger image

Information obtained from the online worksheet includes:

1. A temporal and contextual understanding of a student’s regulation concerns affecting performance throughout the school day in response to the following factors:
   
   
   1. Antecedents to the school day.
      
      
   2. Performance/participation expectations combined with coping with physical, hormonal, cognitive, and/or sensory impairments.
      
      
   3. Fatigue prompted by stress inherent in the school setting.
      
      
   4. Difficulty with scheduled transitions, curricular changes, or unexpected breaks in school routine
      
      
2. The student’s use of inappropriate strategies that undermine his/her ability to meet academic challenges.
   
   
3. The success or failure of intervention implemented by teacher, team, and parents.
   
   
4. Activities, tools, or modifications to prevent student breakdown and enhance future performance.
   
   
5. Patterns of use and prediction of need for an aide in the classroom
   
   
   

SOTL’s Day Logs are the paper and pencil compliment to the Internet program. The Day Log comes in both a Long Form and a Short Form—each corresponding to the Short Form and Long Form data entry pages in the computer program. Both are checklists combined with a space for writing one or two words of description. Therapists should expect to in-service teachers and para-professionals to the log’s use and terminology. Therapists or certified therapy assistants will enter collected data into the Internet program.

The Short Form divides the school day into four segments, early and late morning, early and late afternoon. Keep in mind that it is designed for quick charting. Prioritization is recommended. Targeting one to three class segments per time period may be most beneficial; however the entire day may be charted if desired.

The Long Form log: a matrix checklist that chronicles the student’s performance in small increments of time. It enables the user to account for mood changes and interventions, and to track occupation from the student’s arrival to his or her return home in a detailed, yet concise format.

The following table may be used as a quick reference for the reader’s convenience while reading the case studies.

Quick Reference Table Click on picture to see larger image

Sam

Sam is twelve years old. He lives with his mother and her new husband four days a week. He spends the remainder of the week with his father. Both parents live in a rural township but their work involves a great deal of travel. When they are away, Sam is left in the care of the family maid.

Sam has been diagnosed with Autism. He is in the fifth grade of a local grammar school protected by an Individualized Education Program (IEP) that helps optimize his participation socialization in class. Up to this point, his parents have been extremely proud of Sam’s progress, citing him as a “poster child for autism” when referring to his ability to work within an inclusive school setting. But fifth grade is proving difficult. Sam is a year older then the other children in his grade and has begun to mature physically. His classes are larger and noisier. Students are expected to work in small groups and to interpret a highly conceptual, verbally presented curriculum.

Sam often disappears from the general classroom by running into a small-attached office. Once there, he burrows into a beanbag pillow until he is calm enough to sit at a small table and draw or write long lists of words copied from an atlas. He leaves his retreat for gym, library time, or to perseveratively air his grievances about his parent’s divorce or graphically comment on his growing awareness of his sexuality to classmates. His disruptive behavior has resulted in his teacher asking him to leave the classroom. Sam responds by physically attempting to kick her or by running into the bathroom and stuffing the toilet with paper towels.

Until this current crisis developed, no one had considered the effects of change in Sam’s life or body. It seemed that large parts of the day were now spent alternately placating or restraining him. The school’s itinerant occupational therapist felt that the quiet side room and the beanbag chair provided a glimpse of a sensory strategy that had been outgrown. Academic supervision appeared to have become inconsistent. The school team began to question the extent of Sam’s educational progress.

The occupational therapist suggested that the team utilize a temporally based, evaluative tool, SOTL to learn how Sam actually fulfilled his occupation throughout the school day. She hoped learn more about Sam’s rhythms and habits so that she could realistically provide appropriate sensory support to encourage Sam’s participation in school. The team agreed. They hoped to meet their educational objectives.

The school psychologist also decided to complete a Functional Behavioral Analysis to capture Sam’s subjective comments. The team, which had successfully used both tools while problem solving for another student, approved. They felt that SOTL’s easy to read graphic charts would help Sam’s parents understand their concerns and would be a springboard for proactive planning.

Example – Long Form Text Click on picture to see larger image

The combination of the Student Occupational Time Line and the Functional Behavioral Analysis confirmed the pervasive nature of Sam’s problems and illustrated their affect on his school day. Sam was dwelling on the changes at home and within his body. Confused and anxious, he would explode into disruptive behavior that further isolated and frustrated him. He was not learning and it was clear that spending a large part of the day in a small room with the company of a single adult aide poorly fit the intent of a Least Restrictive Environment clause contained in the Individuals with Disabilities Education Act.

The team invited Sam’s parents to a meeting before the Christmas break. Work samples, Sam’s collected comments from the Functional Behavioral analysis and the graphics provided by SOTL formed the basis for intense discussion and planning. Sam’s father was particularly moved by the visually presented temporal information on SOTL’s charts and commented that that, alone formed a convincing argument for a new plan of action.

Although it would require an early, unexpected change, parents and team decided to prepare Sam for a midyear move to middle school. There, a cross-categorical program serving up to twelve students might better implement individualized educational programming. Although the instructional methods were not tailored to specifically meet the needs of a student with autism, the increased visual and hands-on methodology would help Sam focus on academics.

January- Post Transition: As Sam settled into his new routine, his team met to evaluate his adjustment and progress. It seemed that the change to middle school was successful. Sam’s interactions with other students were more appropriate. He seemed proud of his new status as a middle school student although he occasionally commented that he was tired of “practice” and wished he were back at the grammar school.

The school psychologist included Sam in a lunch group to hone his social skills. His peers in the group modeled good coping strategies and their company widened Sam’s base of acquaintances. The occupational therapist added Sam to her caseload and established both direct and consultative programming for him. The positive relationship that developed between the teacher and therapist prompted a request for classroom observation when the teacher became concerned by a sudden change in Sam’s behavior. He began to randomly yell out in class at unexpected intervals. The therapist and teacher decided to use the SOTL to track the disturbances because of their perceived random nature.

Example: Segment of Long Form/Text Click on picture to see larger image

After a week and a half, SOTL’s charts revealed a clear pattern of brief modulatory disturbance once every hour. The occupational therapist was both startled and reassured by the regularity of incidence which suggested that Sam was reacting to a repeated stimulus in his environment. Observation in the classroom showed that the class bookshelf and pencil sharpener were situated next to Sam’s desk. He was visually and auditorily startled when students rushed toward him to exchange books or sharpen pencils. Once Sam’s desk was shifted and temporary partition erected to shield him from disturbing distractions, the rest of the school year passed without incident.

Looking forward to the next term, the school team suggested his parents enroll Sam in a program that was being designed to meet the learning styles of children with autism. His parent’s hesitated. They were used to and liked a full inclusion rather then the proposed and experimental mainstream model presented for their consideration.

Team members acknowledged that the move to the cross categorical classroom had provided a smooth the transition from grammar school but doubted that Sam’s academic needs would be met over the next three years without the benefit of specifically tailored programming. After prolonged discussion, Sam’s parents agreed to the change. They asked that SOTL be utilized to check occupational engagement once their son settled into the new program. Sam’s father said, “I understand the visual information far better then the verbal. It would reassure me to see my son’s progress.”

The district’s resource program for children with autism opened, as planned, with the beginning of the 2002 school year. Each student entering the program had an individually designed curriculum that built on personal strengths and supported him/her as needed. The transition from the cross-categorical classroom to the smaller self-contained room created some difficulties for Sam. He worried because he had “practiced” in a classroom with twelve students. Now, there were only four. But his enjoyment in math and tech classes, mainstream choices, combined with the proprioceptive input of carrying heavy books from class to class reassured him. He settled in after a few weeks.

Mid year, Sam’s parents indicated that they were still uneasy with the program and their son’s progress. They reported that Sam was often angry or unhappy at home and felt that his interest in school had decreased. They reminded the team of its promise to use the Student Occupational Time Line to check occupational engagement once their son settled into the new program.

Example Long Form Text Click on picture to see larger image

Sam’s parents request afforded an opportunity for the team members to meet after administering the Student Occupational Time Line and to study information it contained as they considered the scope of changes inherent in Sam’s current placement. His teacher indicated that educational involvement and academic achievement had increased with the new curriculum. The school team working within the classroom noted Sam’s improvement in communication and making appropriate choice. They felt that the change attested to success of the room’s rich sensory environment, the use of a personal schedule, and a conflict resolution program that was teaching Sam to appropriately voice his needs or worries.

The occupational therapist pointed out that the teacher’s perception of academic involvement was indeed, correct. Sam was spending most days fully involved in classroom tasks. At times, his aide had been able to fade-out services, giving him full independence. At other times, he remained dependent upon minimal or moderate guidance. The adjunctive sensory supports that had been placed in the resource room (e.g. trampoline) afforded short intensive breaks. But the OT suggested that some additional sensory support might be needed. Sam’s school schedule dictated he spend the first two and a half hours of his day in mainstreamed classes. She wondered if rescheduling so that Sam received a short heavy work break mid-morning might be beneficial.

The team decided that the combination of the end of the school year and fixed middle school schedule precluded rearrangement of current scheduling. However, an accommodation could be arranged for the coming term. Problem solving together, the team determined that an appropriate intervention would consist of a five to ten minute repetitive, structured, heavy work, and pre-vocational task to assure transparency in the school setting. During the annual review Sam’s accomplishments highlighted the success of the new curriculum. His parents were thrilled with his concrete progress and agreed to continue to participate in the program in the coming year.

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