My Experience Shadowing at School-Based and Pediatric Outpatient Clinics
November 11, 2025
by Makayla
Externships Fieldwork Getting Involved
In continuation of my previous blog, My Guide for Finding Volunteering and Shadowing Opportunities, I wanted to share some of my experiences this past summer, where I volunteered at two different pediatric outpatient clinics and shadowed with a school-based Occupational Therapist. As an aspiring Occupational Therapist in the future, these experiences align with my innate desire to understand pediatric patients’ experiences and their application to broader implications on healthcare outcomes and treatment approaches in the field of Occupational Therapy.
Pediatric Outpatient Clinics
This summer, I volunteered at playSense and Kids in Motion Pediatric Therapy, where I gained invaluable exposure in considering a career working in pediatric outpatient clinics. I found these clinics via USC Chan’s OS/OT Volunteer Opportunities page , and I simply reached out to them through email. Since I am a planner, I reached out during the spring in order to start right away when summer started. I recommend planning ahead because programs and clinics can become bombarded with volunteering and shadowing requests. It is important to reach out and initiate getting involved early!
Here are some important takeaways that I learned!
Volunteering at Kids In Motion Pediatric Therapy
1. Using play and intrinsic motivation to inform the patient’s session treatment and goals
In the pediatric outpatient clinics that I volunteered at, I found that Occupational Therapists would let patients play and pick out their games or activities right off the bat at the start of their session. Then, Occupational Therapists would use these influences to adapt and inform their sessions to empower patients to participate in meaningful occupations with greater independence, ease, and confidence. In doing so, occupations are used as both a means and an end goal to maintain independent skills or to find solutions to challenges that may make participation in daily living difficult. Whether it be through toys, board games, swings, or obstacle courses, kids are intrinsically motivated to engage in activities that they are personally drawn to or interested in. For example, to aid in the development of proper pencil grasp, an Occupational Therapist would have patients use tweezers to pick up small figurines hidden in a container full of rice. Using a spoon to scoop up kinetic sand or puff balls into a toy ice cream cone can also help patients work on their pencil grasp while also working on foundational bilateral skills as well. As a result, the interventions by the Occupational Therapists are made easier for patients in completing treatment goals and applying these skills for everyday use!
2. Therapy exhaustion is real
Oftentimes, I would see that the schedule of the Occupational Therapist was jam-packed, with back-to-back patients with only lunch as their break. It is not easy having to run from one session to another while having to debrief parents at the end of a session and then jump to introduce another patient at the start of their time. Additionally, patients may cancel or run late, or even sessions can go over time or run short if any difficulties arise. In order to alleviate some of these stressors, I line up the specific toys, materials, or adaptive tools ahead of time for the Occupational Therapist so that we are ready to go when each session starts. In addition, I have a new appreciation for the stillness and calm in between sessions, where Occupational Therapists are able to rest and recharge in whatever time they have left. I can only imagine the exhaustion after the end of a day’s work, so this serves as an important reminder to me to prioritize restorative occupations as well!
School-Based OT - Extended School Year (ESY)
This summer, I shadowed an Occupational Therapist during an Extended School Year (ESY) program. An Extended School Year (ESY) program provides special education services to students with intellectual disabilities extending beyond the regular school year. Many times, ESY programs have smaller class sizes and may be at no cost to parents as well.
I got connected with this opportunity through my involvement with the Asian Pacific Alumni Association’s (APAA) Scholar Program. Alongside receiving a scholarship from the program and participating in year-long service hour requirements, we are put into families with board members. Fortunately for me, my board member is an Occupational Therapist who also graduated from USC. I had simply reached out to talk with her, and she quickly connected me to an Occupational Therapist whom I could shadow in the school district that she worked in. Easy peasy; the connections in the Trojan Family are real! She has a breadth of knowledge and has since worked in schools as an Occupational Therapist, School Principal, and Director of Special Education. Now, she works at the County Office of Los Angeles, formulating plans to make inclusive college graduation requirements and integrate greater services for individuals with intellectual disabilities across the University of California System and USC. This is all good news!
Here are some important takeaways that I learned!
1. Sitting in on Individualized Education Program (IEP) Evaluation session
While sitting in on an IEP meeting, I learned how comprehensive this process can be in order to determine if special education eligibility is required to fit the educational needs and curriculum of a student. One student’s file contains multiple documented evaluations over time, and different parties are involved in the meeting to consider the intervention plans for a student. This includes Occupational Therapists, Speech-Language Pathologists, parents, case workers, teachers, school administrators, and even lawyers/attorneys. I watched how emotionally laborious these meetings can be, especially for the parents when there is a legal presence and school administration in the room discussing their child. Nonetheless, it is nice to know that these teams of professionals are comprehensive and thorough when formulating educational plans for each student.
2. Career change is normal and encouraged!
The Occupational Therapist that I shadowed had started working in the biology field out of college, working in a genetics lab. However, she sought out a job that had a greater work-life balance when starting a family and decided to change her career to Occupational Therapy when she was 27 years old. If it weren’t for her biology background or her life’s circumstances, she would not have these experiences to inform her direction into the field of Occupational Therapy. Now, as an Occupational Therapist, she has greater meaning and purpose in her career, as well as in the current occupations she participates in.
3. Picking a field in occupational therapy: Personal experiences shape preferences
The Occupational Therapist that I shadowed shared that she had a greater inclination and cause toward working in younger populations because they are sponges for knowledge and have so much life ahead of them. She wasn’t attracted to older populations as much because they reminded her of her father, who dealt with Parkinson’s Disease, and this deeply affected her. She had been around hospice care and hospitals for a good while, and she knew that this field was not for her. On the other hand, her colleague, who is also an Occupational Therapist, enjoys working with older populations within geriatric care. The motivation for this person was working with people who were able to live out their whole lives and have extensive knowledge from their lived experiences. As a result, personal experiences can shape personal preferences, leading to greater motivations to serve specific populations.
4. Teacher, Occupational Therapist, and Speech-Language Pathologist - Same team, different roles
I found that balancing the needs of the teacher, Occupational Therapist, and Speech-Language Pathologist can be challenging when disrupting the student’s educational flow; however, maintaining a careful balance and encouraging intersectional collaboration between them all is crucial for worthwhile results. Sometimes the same student may need the services of both the Occupational Therapist and the Speech-Language Pathologist, so careful planning of classroom activities and schedules can help maximize the student’s time in these services. Additionally, The Occupational Therapist that I worked with utilized the push-in method, where they provide support directly with the student in the classroom. This intervention supplements the classroom instruction, instead of pulling the student out of the classroom for separate instruction.
5. Sensory Integration in a school setting can be hard, but worthwhile
Sensory integration is a therapeutic framework aimed at aiding individuals in organizing and responding to sensory information from their bodies in relation to their environment. While volunteering at the pediatric outpatient clinics, sensory integration was everywhere; however, in a school, these interventions can be hard to do within the confines of the school’s resources, funding for equipment, and school schedules. However, if sensory integration can be supported in school-based occupational therapy practice, it can have a wide range of benefits in supporting student participation, inclusion, and regulation in schools. Learn more about Ayres Sensory Integration (ASI) here:
Check out more about Ayres Sensory Integration (developed here at USC Chan!)
6. Caseload vs. Workload
Caseload is the total number of students that the Occupational Therapist is responsible for supporting; however, the workload encompasses the amount of time and effort to support a student directly, and indirectly, through additional tasks and responsibilities that go into advocating for a student’s support towards their goals. Yet, in many school districts, only their caseload is recognized, which can invisibilize the extensive labor in additional responsibilities and can lead to burnout. School-Based Occupational Therapists are responsible for more than just treatment of students; Ongoing evaluations, IEP meetings, consultations with school administrators, and traveling between schools are just a short list of items that a School-Based Occupational Therapist covers.
Additionally, based on the school district, there could be one Occupational Therapist servicing multiple schools, leading to extensive travel time and careful planning to mitigate conflicts in scheduling. The work that School-Based Occupational Therapists do is invaluable to student success; however, it is difficult sometimes to quantify the depth and impact that they make in students’ lives. As a result, it is important to recognize setting healthy boundaries with the responsibilities that one manages, as well as advocate for greater school resources to supplement and support one’s role as an Occupational Therapist.
7. Occupational Therapy advocacy in the state legislature
The Occupational Therapist that I shadowed expressed challenges in explaining Occupational Therapy services and advocacy, especially in schools and state legislatures. She expressed that there are so many nuances and subtleties that come with the job that she did not know before entering the profession. Fortunately, since shadowing her, there have been great leaps in Occupational Therapy advocacy in the state legislature. California’s governor, Gavin Newsom, has since passed the California Bill AB 1009 law as of October 11, 2025, which modifies the current law to increase professional equity for Occupational Therapists and Physical Therapists to earn school-based administrative services credentials. In doing so, this is a huge stepping stone in giving state-licensed and highly educated professionals a pathway to pursue administrative leadership, opening doors for greater Occupational Therapy impacts on schools for generations to come.
When volunteering or shadowing, I’ll leave you with some parting advice:
- Take the pressure off
Remember that this is your experience, so you get to ultimately decide what you want to get out of volunteering or shadowing experiences. Keep an open mind and flexible when entering a practice because you never know what you may encounter or find interesting. - Be real with your commitment
Although certain programs may have a specific schedule, be sure to block specific times to attend to this commitment. Changes in your schedule may happen, however be conscious of your time and their time as well. Sometimes you may be more available during the summer than during the school year. It is all up to you, however, keeping a consistent routine in your schedule is beneficial in establishing these relationships long-term. - Ask questions
No question is too dumb to answer. It is your experience at the end of the day, so the squeaky wheel gets the grease! A great question to ask is “In what ways do your professional and personal endeavors empower you to support the growth and development of the clients and students you work with?” - Have a notebook in hand
For me, I keep a small notepad to jot down notes during volunteering or shadowing sessions, where I write down observations or any questions I may have for an Occupational Therapist. For me, when I am shadowing a session, my main focus is observation, so as to keep the session as natural as possible and so as not to disturb the session. However, sometimes an Occupational Therapist may call upon me to participate with the patient as well, such as with a game or interactive activity. After a session, I will debrief with the Occupational Therapists on any questions I may have. Later, I add these notes to my own database of Occupational Therapy experiences! - Adhere to their dress code
Dress for success! Many times, volunteering or shadowing programs have a dress code, and it is for specific reasons. Having appropriate attire, especially when dealing with different populations, is crucial for stepping into a practice. For example, do not wear any dangly jewelry because it can be a safety issue in many settings that can potentially injure you. Don’t forget to wear your volunteer badge for easy identification in a clinic, if your program issues one as well! - Remember to get any medical clearances!
Many times, this may be proof of vaccinations or TB (Tuberculosis) tests in order to clear you to start at a practice. Try to do so early, and plan ahead so that you can get to volunteering or shadowing quicker!
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