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Occupational Therapy (OT) is a related service available to assist students with disabilities accessing their education. School-based occupational therapy helps students with disabilities participate in their educational environment and in the educational process through the use of interventions, adaptations and modifications. Occupational therapists and Occupational Therapy Assistants work with students, families and school staff to utilize various strategies and modifications enabling students to participate in a variety of school related occupations such as:
Assistive Technology
Fine Motor Skills
Handwriting
Organizational Skills
Personal Care
Sensory Strategies
Social/Play Skills
When is it appropriate to request an occupational therapy evaluation?
A request for an evaluation may be initiated when the IEP Team has concerns that a student’s fine motor, visual motor, sensory processing and/or personal care skills are having a negative impact on the student’s ability to access the educational environment and/or to participate in the educational curriculum. This request for an evaluation can occur during the initial certification process or as part of a reevaluation when the IEP Team needs additional information to determine if a related service is required to enable a student to benefit from his/her special education.
Can a private evaluation be used as a basis to determine the need for occupational therapy as a related service?
No. A private evaluation can provide useful information; however, a school-based evaluation would be necessary in order to appropriately assess functional skills in the student’s specific educational setting. A summary of the private evaluation can be added to the Assessment Summary in ECATS and linked in the Review of Existing Data section to be included in the Eligibility Determination/Reevaluation Report.
What is a Sensory Processing Evaluation and when is it required?
Starting January 1, 2020, a sensory processing evaluation is a required component for determination of eligibility for the Exceptional Children category of Autism. A sensory processing evaluation collects, organizes, and analyzes information specific to how a student’s current level of sensory processing impacts occupational performance and participation at school. A sensory processing evaluation must be completed by an occupational therapist.
How is a request made for an occupational therapy evaluation?
As with any evaluation, the IEP Team convenes to discuss the possible need for an occupational therapy evaluation. This request can be initiated as part of the initial evaluation process or as part of the reevaluation process. A parent may also submit a request for an evaluation in writing via email or written request to the school team. If a parent makes a verbal request, then the school team has the obligation to inform the parent to put the request in writing. If the team determines that a request for an occupational therapy evaluation is warranted, then the following steps must be completed:
Conduct an IEP meeting to discuss the request for an evaluation (Referral or Reevaluation Determination) and have the parent/guardian sign the Consent for Evaluation.
Complete the OT Referral form located in ECATS. Open the Student Documents and select Referrals in the Documents section. Once the final document is created, the case manager should email a copy to the Lead Occupational Therapist, paige.schreier@cms.k12.nc.us. This referral should be completed as close to the signing of the Consent for Evaluation as possible to provide ample time for the student to be evaluated prior to the IEP results meeting.
The IEP team determines the need for occupational therapy services based on the student’s goals and objectives, desired student outcomes and recommendations by the occupational therapist. To be included on a student’s IEP, occupational therapy must be required to assist the student to benefit from special education. This implies the following:
• The student has a disability.
• Occupational therapy interventions are educationally relevant and clear in purpose.
• The specific knowledge base and expertise of the occupational therapist/assistant is necessary in order for the student to make progress with IEP goals in the least restrictive environment.
OT services may be indicated if the answer is ‘yes’ to the following questions:
• Does the student require the specific knowledge and expertise of an occupational therapist at school in order to make progress and benefit from his/her special education program?
• Does the student require occupational therapy in order to have access to an appropriate education?
OT services are not indicated if the answer is ‘yes’ to the following questions:
• Could the need be addressed effectively by other EC staff?
• Could the need be addressed effectively by other school staff (e.g., school nurse, guidance counselor, teacher, teacher assistant, administrator, and/or cafeteria staff)?
There are a variety of delivery models utilized with therapy intervention. Effective therapy services generally include a combination of models to meet the unique needs of each student. These models include, but are not limited to the following:
• Working directly with a student within the classroom/educational setting in an inclusion/integrated model
• Working directly with a student in a separate room/area away from peers to address specific skills that can ultimately be integrated into the student’s daily routines
• Observing and analyzing student performance to determine if strategies/modifications need to be changed or if new strategies need to be implemented
• Training and collaborating with parents and school staff
• Identifying, selecting and adapting special materials and equipment
What is a Supplemental Aids and Services (SAS) level of service?
Supplementary aids and services (SAS) describes aids, services, and other supports that are provided in regular education classes, other education-related settings, and in extracurricular and nonacademic settings, to enable children with disabilities to be educated with nondisabled children to the maximum extent appropriate. The SAS model is a consultative level of support from a related service provider to ensure a student has access to his/her educational environment. The SAS is part of the IEP and the need for SAS services is a collaborative decision made by the IEP team. The related service provider is responsible for making recommendations and specifying the details of the SAS in the IEP.
Therapy sessions can take place in any part of the school environment. This can include the school grounds, bus lots, hallways, playgrounds, cafeterias, restrooms, classrooms, special classes (i.e. media, art, PE, music, computer) and off-site (fieldtrips and job training sites) when appropriate.
The therapist should choose an integrated model, whenever appropriate. This means the therapist will be working with the students in their typical environment while they are performing routine activities of their school day. At times when teaching a new skill, the therapist may work with students in a separate room/location outside the typical classroom. However, the focus is always on integrating that skill performance into the students’ daily routines to enhance classroom/educational performance.
When is it appropriate to exit a student from occupational therapy as a related service?
An exit (or graduation from occupational therapy) may be indicated based on one or more of the following:
Therapy goals have been met and no new goals/objectives are appropriate or require the expertise of an occupational therapist.
The skills of the school/IEP team are sufficient for the student to continue to make progress in his/her IEP goals without occupational therapy intervention.
Modifications/accommodations are in place in the educational environment to support the student in his/her special education program and no additional adaptations are indicated that require occupational therapy intervention.
Therapy would be detrimental due to a change in medical or physical status.