About 25 miles west of Custer by way of Highway 16 sits the tiny community of Elk Mountain. “It’s about a 40 minute drive depending if there’s wildlife going through Jewel Cave National Park,” says Michelle Lehman, Certified Occupational Therapist Assistant at Custer Hospital. “You end up on a dirt road and cross three cattle guards to get there.”
The smallest school district by enrollment in the state of South Dakota, Elk Mountain is an exceedingly rural place in a state with no shortage of rural places. Half a dozen teachers instruct a student body of 17 pupils who range from pre-kindergarten to grade 12. About half of the students live on ranches, though most of the kids’ families have livestock of some kind or another.
Twice a month for the last two years, Michelle has been making the trip from Custer to Elk Mountain to provide Occupational Therapy (OT) on behalf of Monument Health for students who need additional help to be successful in the school setting. “Primarily, we are there for the kids that qualify on an Individual Education Program (IEP) for the related service of OT,” says Michelle. “But because it’s such a drive out there, some of the other services that we offer are screenings and then just general recommendations to help kids with their focus and attention.”
Michelle sometimes employs Balance/Auditory/Vision Exercises (BAVX) therapy techniques that help students with coordination and concentration. Currently she works with two students, one in fourth grade and one in fifth, though she hopes one of them will have gained the skills to test out of the program next year.
Michelle also has standing OT appointments with Edgemont school. And she partners with Dominique Mendoza and Roni Hanson, Certified Occupational Therapists at Custer Hospital, who provide support with Michelle to provide the best services possible to these rural settings.
“When I started here back in 2000, we had Fairburn, Spring Creek and Pringle in the Custer school district. And those have since closed, so the rural school setting is getting more uncommon,” Michelle says. “One thing that I’ve noticed working in Elk Mountain and Edgemont is that the relationship between the therapist and the staff is more positive than in some bigger schools, and they almost treat me like I’m one of theirs, which is very nice. It’s a relationship where you can grow and have more intense conversations and bounce ideas around, just because you have more time available.”
Plus there are additional perks to practicing in a rural environment, “I thoroughly enjoy the drive out there because it’s relaxing and beautiful, even if it’s snowing out,” Michelle says. “And I look forward to seeing the progress of the kids. I mean, when you have a kid that has difficulty writing or copying words from the board onto the paper, to see them be able to focus, to copy that information and to do it legibly so the teachers can see it, that’s the rewarding thing. It’s not just me; it’s the whole team that is allowing that student to grow and to achieve to the best of their ability. That’s what I enjoy.”
Story: Kory Lanphear