Angela Hathy (MOT ‘10) recalled that her school-based fieldwork at Pitt Occupational Therapy (OT) had been incredibly enjoyable. However, after graduating and spending about a year in skilled nursing, she began to see that while pediatric work came with its challenges, it hadn’t felt as difficult for her because it was the right fit.
That realization launched a career path that would include working in brick-and-mortar school therapy, teletherapy with Pennsylvania cyber schools, and ultimately a position managing 150 students in the Mt. Lebanon School District near Pittsburgh through the regional public education agency, the Allegheny Intermediate Unit.
Strengths of Pitt OT
When asked what from her Pitt education really stuck with her, Hathy pointed to some courses that might be surprising.
“There’s a lot of information that you wouldn’t think necessarily applies from neuro coursework to school-based practice,” she noted. “But as things have changed, we’re keeping a lot more kids in the mainstream public schools that typically would have been in specialized school programs.
“The pediatric assessment course was understandably highly valuable, especially because the instructor taught us how to connect assessment findings to skill deficits, and then to interventions.”
The Pitt OT courses that analyzed movement and focused on transfer training to safely move individuals from one place to another came into play more than she expected. “In the school setting with kids that have more significant disabilities, we need to use those skills. Teaching other caregivers not only how to do it but how to do it appropriately and accurately—those skills are very helpful.”
Working on Interdisciplinary Teams
“Another valuable skill that I learned at Pitt is being part of an interdisciplinary team,” she said.
The Individualized Education Plans (IEP) meetings that Hathy joins include a team of general education teachers, special education teachers, the principal, speech therapists, physical therapists, guidance counselors, social workers and parents. She works with the team to identify goals she can address, track and collect data on. She prioritizes being at each meeting to advocate for her students’ occupational therapy needs and how her input can inform the other disciplines providing their services.
The Teletherapy Surprise
For a profession built on hands-on intervention, teletherapy seemed impossible. Teletherapy provides expanded access to one-on-one occupational therapy services to a student in a virtual environment with support of their caregivers. But starting just before COVID hit, she discovered it challenged her in productive ways.
“[Teletherapy] really challenges your brain and your thinking and your creativity because you need to be really creative to get these kids interacting.”
Therapeutic use of self became even more critical. And there was an unexpected benefit: the family connection.
“I love teletherapy because I can connect to families that I couldn’t easily connect to within the school setting. Parents don’t see our treatment sessions in schools, but in teletherapy, they do. They participate and facilitate their child through the session.”
The Evolution of School-Based OT
Since graduating from Pitt in 2010, Angela has witnessed dramatic changes in the field. and her occupational therapy role has expanded. “Initially it seemed very motor based. Now we’ve evolved into being sensory experts, motor experts, handwriting experts, executive functioning experts, ADL experts and more. There are so many things that they look to my expertise as an OT for.”
Parents now reach out about everything from left-handed adaptations (after seeing it on TikTok) to feeding and clothing fasteners. Just recently, a parent she’d never met emailed asking about an OT evaluation for self-feeding and buttoning.
The Paperwork Reality
Current students and recent graduates should know that with 150 students on her caseload and attendance at most IEP meetings, time management is critical. The demand of the caseload is doable but can be overwhelming at first when starting.
Her schedule includes:
- 2 days: Paperwork (evaluations, re-evaluation reports, progress updates, COTA supervision)
- 2 days: Direct intervention
- Daily: Email consultations with teachers, classroom observations
The Handwriting Evidence Dilemma
Along with cutting skills, handwriting goals are common for early education caseloads. The challenge is to build foundational skills while keeping goals educationally relevant.
“I always tell families and teachers that the symptom is messy handwriting and I need to determine in what way is it messy? Is it line awareness? Is it visuospatial? Is it visual perceptual?” she explained.
It’s a creative threading of evidence-based practice within educational systems—exactly the kind of clinical reasoning Pitt emphasized.
Advice for New Grads and Current Students
Hathy’s journey offers several insights for the Pitt OT students:
- That “easy” fieldwork feeling might be a sign: If a setting feels natural, it might actually be the right fit.
- The challenging setting has merit: Trying skilled nursing taught her what she didn’t want, which clarified what she did want.
- Educational law is learnable: Understanding educational law and where OT fits can be challenging. She recommends using resources like Pennsylvania’s OT/PT school-based guidelines to better grasp the laws impacting OT services.
- Don’t dismiss settings too quickly: She initially didn’t think teletherapy could work for OT, but it became one of her favorite experiences.
- Each setting has its own culture: Many workplaces have their own culture including many school districts and it is important to observe and learn about.
Staying Connected to Pitt OT
For those students considering school-based practice, Hathy’s experience illustrates both the complexity and the rewards: collaborative teams, meaningful family partnerships, professional autonomy and the satisfaction of applying Pitt OT’s foundational education in evolving ways.
Fourteen years after graduation, those Pitt OT courses in assessment, neuro, movement, interventions, health policy, management and interdisciplinary collaboration continue to inform Hathy’s daily practice—often in ways she didn’t expect.