#86 Emotional Disability and OT with Michelle Flemen-Tung

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Learn more about our guest: Michelle Flemen-Tung, MSEd

Children with emotional disability (also known as emotional disturbance) are significantly more likely than children with other disabilities to:

  • NOT be integrated into regular classrooms
  • Experience a disciplinary removal
  • Drop out of school

Over the years, multiple social-emotional learning (SEL) interventions have been developed to support children with emotional disabilities. But, New York City Public Schools found that one-size-fits all programs were not sufficient for their student population.

So, the district created—and began studying—an educational pilot called the Path Program. At the heart of this program are OT professionals :purple_heart: and occupational therapy concepts.

The journal article we are reviewing in this 1-hour CE course describes the research-practice partnership that supported this program’s development—and the role of trauma-informed care in social-emotional learning interventions.

After we review the article, we will welcome Michelle Flemen-Tung, MSEd, the program director for the Path Program. She will share concrete ways we can all improve the support we provide to kids with emotional disabilities.

:white_check_mark: Agenda

Intro and breakdown of journal article

Discussion on practical implications for OTs

  • 00:12:57 How the Path Program came to be
  • 00:18:42 How is the program funded?
  • 00:22:35 How has the Path Program change you?
  • 00:26:30 Article impressions
  • 00:30:33 What is the role of OT in this program?
  • 00:35:28 What can other school OTs takeaway from this program?
  • 00:40:14 What can we take away about trauma informed care?
  • 00:45:45 What kernel-sized interventions can OTs take away?
  • 00:53:51 How can OTs spearhead a similar programs in their school?

:white_check_mark: Supplemental Resources

Resources mentioned in the episode

Supporting Research and Journal Articles

:white_check_mark: Article Review

Read Full Text: Adapting SEL interventions to meet student needs: A research-practice partnership supporting students with emotional disabilities
Journal: Social and Emotional Learning: Research, Practice, and Policy
Year Published: 2024

What is social-emotional learning?

Social-emotional learning interventions encompass a wide variety of approaches. At the most basic level, SEL is the process of developing self-awareness, self-control, and interpersonal skills that are vital to a person’s success in school, work, and life.

These interventions do seem to hold promise, as large-scale systematic reviews have found that SEL had a small positive effect on reading, mathematics, and science skills when compared to traditional methods. SEL can also help lower emotional distress.

But, while there is promise in SEL, there are also problems.

One-size-fits all SEL programs may be less relevant for:

  • Students of color
  • English language learners
  • Students with disabilities

(I would personally add that one-size-fits all interventions are also problematic from a neurodiversity-affirming perspective—an issue that is well covered in this podcast episode from Learn Play Thrive.)

Given this emerging research, scholars and practitioners alike have argued that SEL must be applied in context—and in a way that is responsive to student needs.

What is the Path Program?

This paper was written to describe the creation of an education intervention called the Path Program.

New York City Public Schools developed the Path Program for students with emotional disabilities (who are disproportionately Black, male, and low-income).

Here’s how a press release described the program in 2022:

Core elements of the (Path) program include a small class size, two full-time classroom teachers, in-class and out-of-class support from a social worker and occupational therapist, and collaborative partnership among families and school staff. Path classrooms are grounded in principles of culturally responsive and strengths-based education and evidence-informed practices including positive behavior and self-regulation support, social-emotional learning, and trauma-informed care.

The Path Program is also supported by a research-practice partnership with researchers and practitioners from New York University.

Intent of this article

The intent of the article was to explain how the research-practice partnership supports the adaptation and implementation of the Path Program.

The program utilizes a continuous improvement model called Plan Do Study Act.

How the Path Program is being implemented

Launched in 2021, the research-practice partnership was created to increase the district’s support of students with emotional disabilities.

At the time of this paper’s publication, the program was up and running in 13 classrooms across 6 elementary schools.

Collaboration among teachers, occupational therapists, and social workers is key to this program’s success.

Teachers lead SEL strategies in the classroom, while OTs and social workers guide program implementation.

OTs specialize in supporting students’ behavioral regulation through:

  • Classroom environmental design elements
  • Classwide regulation support
  • Individualized strategies (like programs for students with sensory needs)

Social workers support students’ emotional awareness, regulation, and expression through both whole-class and individualized trauma-informed strategies and clinical services.

Here’s what the Plan Do Study Act cycle looks like:

Plan

The program uses both targeted and universal strategies.

Core to the vision of the program are “bite-sized SEL kernels” that allow for flexible implementation. Ideally, these “SEL kernels” are low-cost, targeted, and evidence-based strategies.

Staff are trained on a “menu” of these strategies so they can implement appropriate activities whenever they make sense—as opposed to using a set program in every situation.

Activities are sourced from the Bounce Back program—specifically, the program’s Body Feelings and Relaxation Training .

Trauma-informed care is also integrated into the Path Program. For example, students are not expected to self-regulate. Rather, the program is designed to provide adult support through co-regulation.

Do

The research team from NYU does not directly implement the Path Program in schools. Rather, they assist with training and ongoing consultation.

Staff in the program participate in a multi-day pre-service training led by university practitioners and district leaders.

Study

The researchers conducted monthly 60-minute classroom observations. They administered an in-depth survey midway through the study. They also conducted brief surveys at the end of staff training.

2 areas of improvement were identified:

  1. School staff reported that they responded to frequent incidents of dysregulation, during which they did not feel confident supporting students.
  2. Staff reported feeling burdened by program implementation.

2 courses of action were agreed on:

  1. Teach staff more skills for both developing students’ regulation skills AND de-escalating situations as needed.
  2. Streamline and align SEL activities with other district programs to help make implementation more feasible.

Act

2 major changes were made to the program, which will be studied in upcoming cycles:

  1. To help staff better support students during periods of dysregulation, training on the Therapeutic Crisis Intervention for Schools was provided.
  2. The Body Feelings and Relaxation Training was substituted with Zones of Regulation , which had been used in the school previously—but only by occupational therapy professionals. Because the occupational therapists were already familiar with this approach, they were able to help model it for teachers and assist in wider implementation.

Lessons from the Path Program

With a strong body of evidence supporting impactful SEL activities (see Navigating SEL from the Inside Out, the field of SEL programming is now turning its focus to ensuring that student SEL needs are met in any given context.

The Path Program’s fusion of SEL with trauma-informed care helps address the need for context-adaptable programming.

However, because no one had ever created a comprehensive intervention integrating SEL, academic, and behavioral supports for students with emotional disability in the general education classroom, insights from both researchers and practitioners in this study were critical to successful program implementation and adaptation.

In short, the research-practice partnership allowed program leaders to not only imagine goals for students, but also to take the necessary iterative steps to achieve them.

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Please share any other feedback below! Including, ideas for future programming, and most importantly, how you feel this podcast will impact your practice!

2

I wanted to be the first to share, because since writing and recording this I learned from an interview with Kristie Koenig about how self-advocates were involved in the creation of the Path Program. Here’s what she said:

"We had a self-advocate that was diagnosed with emotional disability—and written off. He came back and trained the therapist. He then instructed the teachers and occupational therapists. He said, “You thought taking me out of class was good, but it was not. I would come back into class, and everyone wanted to know where I got stickers or why I got things they didn’t. It was hell.”

When you start to talk to people who have had a lived experience, you will discover that our service delivery models are messed up. As a result, you can hopefully be more creative from a systems perspective.

Kristie is such and advocate of making sure that the populations we serve have a valued voice in the programs being created, and this quote was such a powerful example to me!

3

It’s exciting to hear about a program that is training and giving educational personnel knowledge in implementing SEL while also emphasizing the importance of flexibility to meet the needs of individual students within the classroom. The Research-Practice Partnership sounds like a critical component as a program incorporating SEL is ever evolving. I’m curious how the Path Program was developed and financially supported.

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That is unfortunate about the student having a difficult time coming in and out of the classroom and other students giving him/her a hard time about the stickers. I always checked in with the teacher to see if the child was prepared to leave the classroom even with a prescheduled appt. They could be having a bad day. The teachers usually had some kind of opportunity for all the students to get rewards and sometimes rewards removed. It doesn’t sound like this was the case for the students at this school. I think there could be an SEL for creating a culture of respect. The stickers be given to the teacher to give to the student at another time or perhaps to the parent. Great article to share with our schools

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5

This was something I was very interested in as well! And, you’ll get to hear on the podcast (coming out tomorrow!) that I ask these questions right off the top!

6

That story from Kristie Patten really stuck with me, as well, @ruthlincoln. I think it really showcases the importance of really listening to our clients, both during the process, but then afterward bringing some back as consultants to improve our offerings.

8

@meg2 and @bryden I was thinking of you both during this episode, and was wondering if either of you had read the two books Michelle recommended??

9

Yes! I have read portions of “Connections Over Compliance”. Absolutely beautiful :slight_smile:

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10

I think I am going to purchase that one—and Michelle really like how actionable trauma informed pedagogy was! I’m going to check that out as well!

While, we are on this topic, @bryden please let me know if you have an suggestions for a guest for an episode based around trauma informed pediatric OT!

11

Great course and resources.

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12

I’m glad to hear that! I also thought the resources shared with this were super useful! I’m excited to ready the books! Just purchasing them now!

14

Thanks, @SarahLyon and @michelle-flemen-tung, for such an intriguing conversation! I can only imagine the statistics on students with emotional disturbance back here in Kenya.

I agree that for collaboration, we have to step out of our comfort zones slightly, and as Michelle guided us, we need to identify the persons we can best work with within the school setting.