SCHOOL BASED OCCUPATIONAL THERAPY

A Related ServicePart of the

Special Education Program

What is Occupational Therapy?

School-based occupational therapy is a related service designed to enhance the student's ability to fully access and be successful in the learning environment.

Occupational therapy combines the art and science of providing and directing activities that serve to restore and enhance performance of skills needed for functional daily living. The occupational therapist uses a variety of tasks and exercises in the areas of self-care, work and play to increase functional independence, enhance development, and prevent disability. The task or the environment may be adapted to promote maximum independence and improve quality of life.

What is Related Service?

Related services are support services for special education and are not instructional services. They are those services necessary for the student to make progress toward the identified instructional goals. Related services may include occupational therapy, physical therapy, music therapy, assistive technology, counseling, and transportation.

The law does not require that such services be provided. Rather, the legal duty to provide a related service arises only when without the service the child’s educational program would become less than appropriate, i.e., when the child would not benefit from his educational program without these services. In determining whether a related service is “necessary” for a student, the district should rely on a related services assessment. (Susan B. Graham, 1996)

What do Occupational Therapists do in the school setting?

• observe a student engaging in an activity and provide strategies to facilitate the student’s full participation;

• reduce barriers that limit student participation within the school environment;

• use assistive technology to support student success;• support the needs of students with significant challenges,

such as by helping to determine methods for alternate assessment;

• help identify long-term goals for appropriate post-school outcomes;

• help plan relevant instructional activities for ongoing implementation in the classroom; and

• assist students in preparing for successful transition into appropriate post–high school employment, independent living, and/or further education.

What areas do occupational therapists address with their students in the

school setting? Fine motor skills: hand development, hand strength,

grasp patterns, pencil grasp, handwriting, dexterity, scissors skills, shoulder/trunk strength and stability.

Self-help skills: manage clothing in the school setting (i.e., buttons, zippers, snaps, tie shoes), feeding skills, and use of adaptive equipment.

Sensory processing skills: provide interventions that remediate the sensory integration issues influencing behaviors in the classroom, make modifications to the classroom environment in order to assist children in participating and progressing at school, playing, making friends, and focusing in order to learn

Who do OTs work with ?

They work with a variety of people such as:• students to improve their performance in a variety of learning

environments (e.g., playgrounds, classrooms, lunchrooms, bathrooms) and optimize their performance with adaptations/accommodations;

• parents to help them support their children’s learning and participation in school;

• educators and other school support staff to plan and develop activities and environments that include all students;

• paraprofessionals to support child success and promote safety within the school environment (e.g., physical and behavioral assistance needs); and

• administrators to provide training for students, staff, and parents, as well as to recommend equipment for schools and ways to modify existing buildings and curriculum to allow access for all.

What is the difference between the medical model and school-based therapy model of

Occupational Therapy?

Medical Model School-Based Model

GOALTo treat the client's continuum of

needs (from acute through rehabilitated status)

To assist a student with disabilities in obtaining

educational goalsFREQUENCY

As neededBased on educational need as

specified by the IEP

PROVIDER/ IMPLEMENTER TherapistSchool personnel, family, student,

therapist

DURATION OF INTERVENTION Few days to several monthsOne-time consult to one or more

yearsULTIMATE DECISION MADE BY: Doctor, therapist, and client ARD or IEP Committee

MANNER OF INTERVENTIONDirect with some family consult; recommendations and provision

of equipment

Direct therapy; and/or the following: consult with

student/teacher, program equipment consultation, individual and classroom

equipment modifications, in-service training

Medical vs. Educational Model cont.

The medical model is more of a "bottom up" approach; the therapists identifies the building blocks and attempts to fix or repair the deficits for improved function. A clinical Occupational Therapist may see a child one on one several times a week to strengthen and rehabilitate deficits.

Occupational Therapy services in the school setting follow an educational model. These services are more of a "top down" approach. In the schools, Occupational Therapists assess the student's functional skills and identify areas of difficulties.

The primary concern for the school Occupational Therapist is enabling the student to learn and access his or her learning environment (classroom, playground and cafeteria). Rather than rehabilitate a deficit, the school Occupational Therapist may adapt or modify the environment or offer the teacher strategies to implement on a daily basis to afford success

How does a child qualify for occupational therapy services? 1. First it must be determined that the child is eligible to receive

special education services.2. An Individual Education Plan (IEP) must be developed to

address the academic areas of concern for the child.3. If the child is not making progress toward mastery of the IEP

goals, additional related service support may be recommended.

4. A referral is made to the occupational therapy team to evaluate the child in the school setting to determine eligibility for services.

5. An IEP meeting will be held to discuss the results of the occupational therapy evaluation. If a child does not qualify, recommendations may be made for additional assistance. The assessment report will include the recommendation for services, including goals and objectives and amount of therapy time.