School-Based Therapy

When occupational therapy is provided as a related service, it is meant to enhance a student’s ability to function in an educational program. By focusing upon the skills of daily living, occupational therapists can often help individual students to function in the least restrictive environment. Generally, occupational therapists provide treatment to strengthen and develop fine motor functions, focus on treatment of the small muscles, primarily those of the face, upper trunk, arms, and hands, and improve the student’s ability to perform tasks necessary for independent functioning, such as chewing, swallowing, placement of the tongue and mouth for speech formation, eye-hand coordination, and manual dexterity.

In relation to special education, physical therapists are primarily concerned with developing and enhancing the physical potential of students with disabilities, so that they can achieve maximum independence and function in all their educational activities.

If a child is identified as having a disability as defined by the Public Law 105-17, the Individual with Disabilities Education Act (IDEA), he or she is entitled to special education. When special education eligibility is determined, the school district develops an Individualized Education Plan (IEP). This legal document outlines the educational supports that the child requires. According to the law, a child is entitled to a related or support service that “may be required to assist a child with a disability to benefit from special education.” Occupational therapy and Physical therapy are related services.

If a team suspects that a child needs the specialized services of an occupational therapist or physical therapist, a referral is made. If an assessment is completed, the team, after discussing the evaluation results, determines if the related service is required for the child to benefit from special education. It is important to remember, however, that educationally based therapy is not intended to be a medical or primary service.

Related services are more easily understood if considered as a secondary service. That is to say, without a primary service to support, there would be no secondary services to provide. Therefore, children who are not deemed eligible for special education would not be eligible to receive a related service.

In the medical realm, however, occupational and physical therapy services are able to be received as a primary or “stand alone” service. Therefore, if you are not eligible for services by your local Board of Education, you may want to pursue possible insurance coverage for therapy.

Bakersfield City School District
Beardsley School District
Kern High School District
Norris School District
Standard School District

• Experienced and knowledgeable therapists that utilize standardized and non-standardized assessments and provide comprehensive assessments that allow the IEP Team to determine if school therapy as a support to the child’s educational program is needed and allow the IEP Team to create plans to address therapy-related needs
• Well-managed and coordinated services
• Team of school therapists to pull from when needed (staffing, mentoring, 2nd opinion assessments, support, supervision)
• Reputation – we have the respect of families, outside agencies, and school employees for TERRIO’s therapists and the opinions and professionalism they bring to the IEP Team
• Consistency – our therapists provide what is recommended and needed for the student with OT or PT on their IEP
• Accountability for regulations, standards, competence, and best practice

A school-based physical or occupational therapy evaluation should include:

• Background information
• Review of work sample
• Interviews of relevant school personnel
• Selection and use of appropriate assessment tools
• Standardized assessments
• Profiles
• Checklists
• Observation of the student in the natural environment
• Direct assessment of identified concerns

Using a discipline-specific approach to evaluation does not reflect the intent of the IDEA.  In this approach, the therapist would conduct an assessment of the student’s needs, possibly using a deficit-based model, in that if the child is unable to accomplish a task, therapy services would be recommended.  Individual discipline-specific goals and interventions would be developed and provided without considering the student’s educational plan.  If deficits are found, treatment is indicated without considering if the specific deficits affected the student’s ability to function in the educational setting.  IDEA intends for collaboration.  Priorities and outcomes of the student’s educational program are to be established by the team before the need for specific services can be indicated.  A therapy evaluation should be done when problems with performance exist that affect a child’s ability to function in school.  Determining if a child has difficulty performing tasks that are necessary for him or her to function in the educational setting is needed.  A contextual approach to evaluation allows therapists to identify, with input from teachers, what a child needs to be able to do in school and his or her strengths or weaknesses relative to the tasks, the setting, and expectations.  Therapists need to consider an approach that will provide appropriate functional and academic information in relationship to the school setting.

Results should be shared in a timely manner with the team so they can make an appropriate decision about the need for OT or PT services. The IEP team is responsible for determining if therapy services are or are not needed for the child to meet his or her educational outcomes.

If the team agrees there are concerns that affect the student’s school performance, they must determine whether he or she needs OT or PT services to achieve his or her goals. The needs may be able to be addressed by other educational personnel (i.e., special education teacher) and therapy services would not be indicated. If services are needed, the team should indicate which of the student’s annual goals and objectives will be supported by OT or PT. There should not be “OT goals”. They are the student’s goals as part of his or her educational program that will be supported by OT or PT as a related service. The team should also discuss and decide on the amount, duration, and where services will be provided. Services may include a combination of direct contact with the student and collaboration with school staff.