OT Toolbox

Last week, I had the honor of sharing a keynote called "The Chair: Moving Beyond Inclusion to True Belonging" at the 3rd Annual Inclusive Communication Conference sponsored by the Autism Foundation of Oklahoma and Down Syndrome Association of Oklahoma.

As I prepared for the presentation, I kept coming back to one simple image: an empty chair.
An empty chair represents every person who has wondered:
• Do I belong here?
• Will anyone notice me?
• Is there a place for me at this table?

One of the most powerful moments of the keynote was hearing from Espy, an incredible young woman who shared her experiences growing up, learning to advocate for herself, and finding her voice.

Her story reminded us that true inclusion isn't simply inviting someone to the table. It's listening to them once they're there.
Because children and adults alike need more than access—they need belonging.

I also shared 10 simple things we can do with a chair to create more belonging in our schools, workplaces, communities, and families:
🪑 Pull up a chair
🪑 Notice the empty chair
🪑 Stop making people earn a chair
🪑 Move the chair closer
🪑 Save a chair for someone else
🪑 Teach others to pull up chairs
🪑 Know your chair
🪑 Leave extra chairs out
🪑 Carry the chair together
🪑 Become the chair

My hope is that we all leave a few more chairs available for the people around us.

Because when people belong, they thrive.

And sometimes the smallest act of inclusion can change someone's entire story.

I'd love to hear: Which of the 10 chair actions resonates most with you?

Mental health is impacting our schools more than ever before.
Did you know?
• 1 in 5 children experience a mental health disorder each year.
• 40% of high school students report persistent feelings of sadness or hopelessness.
• Nearly 30% report poor mental health.

As school-based therapists, we may not be mental health providers, but we absolutely play a role in helping students participate, connect, regulate, and succeed at school.

The challenge is knowing:
✔ What signs to look for
✔ How mental health impacts participation and learning
✔ What supports we can provide within our role
✔ When to collaborate and refer

This month inside the School-Based Therapy Community, we're diving into Supporting Student Mental Health.

Members receive:
• Weekly information on specific topics
• Downloadable resources and toolkits
• Practical school-based strategies

Plus, when you join, you'll immediately gain access to ALL previous content, including:
• Role of Related Services
• Sensory and Behavior
• Documentation
• Dismissal and Service Decision Making
• Templates, guides, and resources you can use right away

The reality is that students can't fully access learning if they're struggling to access themselves.

If you're looking for practical support, real-world strategies, and a community of professionals who understand school-based practice, I'd love to have you join us.



https://stan.store/twarwick/p/schoolbased-therapist-network--jp4oq238

Difficult conversations are part of school-based therapy… but most of us were never actually taught HOW to navigate them.

Whether it’s:
• dismissal discussions
• reducing services
• difficult IEP meetings
• behavior conversations
• parent concerns
• disagreements within teams

These conversations can feel emotionally exhausting — especially at the end of the school year.

I created this practical guide for school-based therapists to help navigate these moments with more confidence, empathy, and clarity.
Inside:
✔ The FUSION communication framework
✔ Stop-Drop-Roll de-escalation strategy
✔ Chunk-Check-Chunk communication method
✔ Dismissal considerations
✔ Mindset shifts that improve collaboration
✔ Practical examples and scripts

One of my favorite reminders from this guide:
✨ “Validation is not concession — it is connection.”

When we lead with empathy, communicate clearly, and stay grounded in student needs, difficult conversations become far more collaborative and effective.

What difficult conversation do you feel least prepared for in school-based practice?

I attended a training last week on Crucial Conversations and honestly kept thinking, “Every school-based therapist and educator needs this.”

We spend so much time navigating difficult conversations:
• dismissal discussions
• disagreements during IEP meetings
• advocating for educational relevance
• differing perspectives between staff and families
• conversations about behavior, accommodations, and supports

One of the biggest reminders for me:
Conflict itself is not the problem. The way we approach conversations during conflict is what matters most.

The training focused on:
• staying grounded during emotional conversations
• identifying shared goals
• listening to understand instead of defend
• approaching disagreements with curiosity
• maintaining collaboration even when perspectives differ

I immediately connected this to school-based therapy and IEP teams. Sometimes we focus so heavily on compliance and data that we forget how much trust and communication impact the process.

If you are in Oklahoma, OKSERC offers incredible FREE trainings for school districts. If you are outside Oklahoma, there are still great free resources available online.

One resource I highly recommend:
Essential Skills for Engaging in Conflict: Six Conversations in Support of Effective Collaboration. This contains six modules that are free for you to use with your team.

One thing I’m continuing to remind myself:
The goal is not to “win” difficult conversations. The goal is to move toward understanding, collaboration, and student-centered decisions.

What helps you most during difficult school-based conversations?

This is great!!

When we talk about getting curious about “what’s underneath behavior”, we’re rarely talking about one tidy bucket of “unmet needs.” Often, it’s a stack of systems that are all running at once, all the time, and all feeding into the same nervous system. And it’s often “invisible” to the child, in the sense that they aren’t able to accurately conceptualize and verbalize the experience.

If you think about this using the analogy of a volcano, what we can see is the “eruption”, that eruption is the end of or result of something, but what we don’t see is everything going on inside the magma chamber (inside of the child). An eruption is loud, visible, and it’s the thing adults react to. But by the time that eruption happens, pressure has been building inside that magma chamber for a long time.

Closest to the surface is the nervous system itself. Nervous systems are constantly scanning for safety. This is called neuroception, and it happens below conscious awareness. The body decides if a situation is safe, dangerous, or life-threatening before the thinking part of the brain ever weighs in. So by the time a kid is in fight, flight, freeze, or fawn, their body has already made that call without them.

Below the nervous system is the sensory layer. Every kid is running their own uniquely coded sensory system that's processing input constantly: lights, sound, temperature, textures, smells, movement, and where their body is in space. Sensory needs are individual, dynamic, and shift with fatigue, stress, illness, and hormones.

The next layer is unmet needs, which includes physiological needs (sleep, hydration, hunger, blood sugar, movement, needing to use the washroom), relational needs (connection, comfort, social belonging, co-regulation, repair after rupture), and developmental needs (autonomy, predictability, competence, agency, downtime).

Children often cannot identify and name these needs in the moment, which means they rely on us to do the tracking and troubleshooting.

Below that layer is communication frustration. Every child communicates. Speech is one channel of communication among many, often not the most important one, and for a significant number of children, not their channel at all. Even for speaking children, expressive language becomes harder to access under stress, and the words for complex inner experiences may not be developed yet.

Many kids communicate clearly through behavior, movement, gesture, stimming, AAC, etc long before an "eruption" happens.

Communication frustration is what builds when a child's communication, whatever shape it takes, isn't being received and understood by the adults around them.

And stacked across all of these layers is accumulated load. Stress doesn't reset between events, it accumulates. This is easy to underestimate and easy to overlook, especially when adults are looking at the eruption and trying to figure out "what set them off." The answer to that questions is often "everything before this moment, plus this moment. "

And at the foundation, the bedrock of the whole mountain that everything else sits on: these are kids who are still developing.

The skills required to navigate daily life are vast, and they develop unevenly, on no fixed timeline. There is no synchronized clock between children, or even within the same child. Capacity to access skills also fluctuates day to day, hour to hour, based on sleep, stress, illness, and accumulated demand. And yesterday's success doesn't prove the skill is locked in. It only shows that yesterday's conditions allowed access to it.

And the deepest WHY:

Children develop self-regulation through co-regulation with safe adults. They do not learn to regulate by being left alone in their dysregulation, and they do not learn it by being punished for it.

They learn it by borrowing our regulated state, over and over and over and over (and over and over and over) until their own system builds the wiring to do it.

Every “eruption” met with calm presence is a deposit in that wiring. Every eruption met with punishment or withdrawal teaches the body that dysregulation equals disconnection, which makes the next eruption bigger because now the child is dysregulated AND scared of being alone in it.

So when we say "underneath the eruption is where the child needs us most," we mean it literally. The child's nervous system is asking for a co-regulator. That's the developmental task. That's how the wiring gets built. That's the WHY.

As the adults, we HAVE TO put this work in for the kids in our lives.

The “behavior” we see is the smallest yet loudest, most misleading part of the whole story. The real child, the real need, the real opportunity, all of it is underneath, inside the magma chamber.

And the adults who learn to look there are the ones who truly help kids grow the capacity they're being asked to demonstrate.

I got to spend all day yesterday with so many school-based therapists, and honestly… it was so refreshing. 💛

Yesterday was such a good reminder that so many of us are carrying the same struggles in school-based therapy. We are all trying to balance supporting students, collaborating with teams, honoring family concerns, and making thoughtful decisions about school-based services.

One of my favorite parts was simply interacting with other therapists, hearing different perspectives, and realizing how many of us are trying to balance the exact same things every day — supporting students, collaborating with teams, honoring family concerns, and making thoughtful decisions about school-based services.

These conversations are not always easy. Dismissal decisions can feel emotional, uncomfortable, and complex. But when we step back and focus on educational relevance, student independence, data, and team collaboration, it helps guide the process in a more meaningful way.

Some of the biggest takeaways participants appreciated from the training included:
✅ Having a rubric tool to help guide decisions
✅ Scripts for difficult conversations
✅ Learning how to better advocate for the role of the related service provider
✅ Simple data collection tools
✅ Preparing families and teams from the very first IEP meeting for eventual independence and dismissal

I truly loved the honesty, vulnerability, and collaboration that came from yesterday’s discussions. It was a reminder that none of us are doing this work alone.

Because so many people asked for the scripts and tools we discussed, I put together “Dismissal Conversations Made Easier” — a practical resource filled with ready-to-use language, talking points, and tools for navigating these conversations with more confidence.

You can find it here:
https://stan.store/twarwick/p/dismissal-conversations-made-easier

Good luck as you all work on wrapping up the 2025-2026 school year!