Our department incorporates two Related Services ‘Teams’
– the Occupational Therapy/OT Team and the Physical Therapy/PT Team.
school-based therapy needs should directly relate to and support his or
her academic program. It is the role of the Occupational Therapist (OT)
or Physical Therapist (PT) to work closely with all members of the
school team to identify and create solutions and/or adaptations that
assist students to participate as fully as possible in their school
setting. OTs and PTs provide a unique perspective of a student based on
their specialized knowledge in child development, motor learning and
task performance. OTs and PTs are trained to provide many types of
developmental services as well as conduct assessments related to a
student's functional skills in the educational environment.
“Related services” are supportive services required to
assist a child with a disability to fully access their special education
curriculum. Both physical and occupational therapy are related
services. Related services may also include other developmental,
corrective, or supportive services if they are required to assist a
child with a disability to benefit from special education. OT/PT are
not determined through eligibility or ineligibility for special
education services. These services must be acknowledged by the IEP
committee and considered at the IEP meeting.
and physical therapy services are provided only when a student is unable
to benefit from special education without these services. Goals may be
academic in nature while other goals will focus on functional
performance in the school environment.
The OT/PT must be an active participant in the decision making process
when determining whether or not a student may qualify for the related
service of occupational or physical therapy.
The IEP team must decide if the student requires OT
and/or PT to benefit from his or her special education program.
The evidence of a delay or medical condition does not necessarily
mandate therapy services. The student’s needs, as identified by IEP
goals, are the driving force for service determination.
As educational team members, therapists work closely with teachers,
families, and the student to identify solutions and implement strategies
that help students participate in their educational program.
educational setting, Occupational and Physical Therapy services are
geared toward ensuring that qualifying students benefit from special
education in the least restrictive environment.
Is School Based Occupational and/or Physical Therapy? What is the
difference between the educational and clinical models?
Occupational and physical therapists are equally trained and licensed no
matter where they work, but the missions of the agency, school, or
clinic where the therapists work are often very different. Therefore,
the type and goals of therapy may be very different from one setting to
another. It’s important to understand the different delivery and
outcomes of different models of therapy.
There are two primary
models of occupational and physical therapy for children: clinical and
educational. The basic purpose behind each of these models is different,
although they can overlap.
Children can receive services through one or both models. An IEP is a
fluid document, it can and should change to respond to both students’
needs and ensure least restrictive environment for the student. For
some children the frequency or intensity of therapy they receive at
school through the educational model will not meet all therapy needs. A
child may have therapy needs outside the school setting that would
require home- or community-based services from the medical model.
HOW DOES IT
parent or other involved person can ask the IEP team to consider
the need for evaluation
• Referral is
initiated by physician based on observed delay or diagnosis
WHO DECIDES NEED
• IEP team
consensus with recommendation from licensed OT/PT based on
testing and classroom/campus observation
takes into consideration only needs associated with
special education program
• Testing and
clinical observation by licensed OT/PT
takes all settings into consideration
driven by doctor’s orders
WHAT IS THE
PURPOSE OF EVALUATION?
• To contribute
knowledge and data to the IEP team for discussion and decisions
• Helps to
identify areas of strengths and needs
• Helps to guide
• To determine
need for services
• Helps to
identify areas of strengths and needs
• Helps to guide
SCOPE OF SERVICE?
team—including parents, student (if appropriate), educators,
administrators and school based therapists—determine the focus,
frequency and duration of therapy
• A doctor’s
order does not drive decisions about school therapy services
• Services are
• Medical team
determines location, focus, frequency and duration of therapy.
coverage, doctor’s orders and transportation may be determining
• Services tend
to be discipline based.
HOW CAN SERVICES
• Changes to
related services require an IEP meeting with parents, educators,
administrators and the school based therapist present to discuss
and come to consensus
• Doctors can
alter orders or therapist can change therapy plan, generally
discussed with doctor and parents
WHAT IS THE
FOCUS OF THERAPY?
addresses access to special education and school environment
• Works toward
independence and participation
addresses medical conditions and impairments
• Works to get
full potential realized
• On school
grounds, bus, halls, playground, classroom, lunchroom; total
• In the clinic,
hospital or home
HOW IS THERAPY
Integrated/inclusive therapy, staff training, program
development, collaboration with staff, group intervention,
direct one-on-one treatments, consultation
responsibilities are often taught and delegated to teachers,
aides and others.
one-on-one treatment to accomplish set goals
responsibilities are delegated, except to parents.
cost to student or family = free and appropriate public
Fee-for-service payment by family, insurance or governmental
Teacher Tool Box
Teachers: We are here to be a support to you. The
resources you will find here are general in nature and not meant to
replace direct therapy services, however we recognize that many of the
tools we recommend and/or use in therapy can be applicable to all
classrooms and for all students, regardless of having a disability or
not. Not every recommendation or tool works the same way for everyone
and research is key to make the best choice for your own purposes!
Pencil grips/Adapted Writing Tools:
children who press too hard when writing, consider the use of mechanical
pencils to assist the child in learning how to grade the amount of
pressure they are using.
Fine Motor Activities
following list consists of fine motor activities to improve grasping,
in-hand manipulation, and hand/finger strength:
shuffle cards, deal
cards one by one, flip cards over
pick up coins and
flip them over without bringing them to the edge of the table
screw and unscrew
nuts and bolts, caps on jars
play travel size
board games with tiny pieces
use clothespins to
move game pieces in board games (ie. pick up pawns in "Sorry" or
"Perfection" puzzle pieces with a clothespin rather than using your
string small beads
onto a string
hand to roll dice
clip clothespins on
a clothesline tear strips of newspaper; crumple newspaper into a
fold paper; make
use scissors to cut
pick up small
objects (cotton balls, pom poms) with tweezers and olive pickers
hide small objects (ie.
pennies, beads, Lite Brite pegs) in playdough or silly putty and
have your child try to retrieve them (you can make it fun by having
them try to find as many items as they can in a minute)
trace objects using
sharpen a pencil
"snakes," or roll small balls and flick across the table with your
fingers to play "finger soccer"
play with pop beads
ring out a wet
punch holes with a
windows with a spray bottle
make an art project
with an eye dropper
Pick up sticks
Ants in the Pants
Don't Spill the
Get a Grip
Perception Games and Activities
following list consists of several activities to improve visual
Rush Hour game
Connect the dots
Paint by numbers
Word search puzzles
Look and find
worksheets (Hidden Pictures)
I Spy Eagle Eye; I
Spy Go Fish
children are easily over-stimulated or distracted by sounds, others by
touch or visual stimulation. Some need motion – of their hands, legs, or
mouth for example – to focus their attention. All need an appropriate
environment, including proper seating. Tool Chest: For Teachers,
Parents & Students provides 26 fun, practical activities to assist
children in developing their optimal range for paying attention,
performing fine motor skills, improving self-esteem, and more. This
self-guided handbook is easy for teachers and parents to use in the
classroom and at home.
Assistive and adaptive technology have always been tools
employed by OT’s to improve independence. In recent years, electronic
devices have increasingly been used by therapists as an administrative,
intervention as well as assistive tool. Although they are never to be
the object of therapy, electronic devices have the potential of being
used as an intervention, assistive tool or cognitive aid for students.
Furthermore, many apps are now designed to facilitate and support the
development of many skills that we address through occupational
therapy. Here you will find technology tools and resources that support
therapists in improving the functional capabilities of our students.
Handwriting App List
Below you will find our favorite tools and tips to help
kids with sensory issues stay calm, organized and focused in school.
Place the band around the front legs of students' chairs
so that they can place their feet behind the band while seated and
stretch it forward. This gives them input and helps with the fidgets!
Headphones or Ear Buds:
Play calming music during stressful noisy times, such as
riding the bus, in the lunchroom, or in the classroom when trying to
encourage independent work. Limiting auditory input will decrease the
brain's processing requirements and distractibility, and will encourage
focus on task. When a child is required to process sounds from different
areas of the environment, it increases the requirement for modulation.
Water bottles with Sipping Tops:
Keep the bottle on the child's table to be used whenever
he or she wants. This can be implemented easily, and is also healthy.
It's small, can be placed in strategic spots (underside of desk or
chair, student's pocket, bottom of ruler or pencil box), is virtually
undetectable to peers, easy to obtain and install, and inexpensive.
These now can be purchased very inexpensively wherever
exercise equipment is sold. Teachers may wish just to keep them on a
shelf in the room for any student to try. Most do, but only the kids who
need it to regulate continue with it. Because all can try it, it is not
a 'special ed' thing for those who benefit from it.
Movement Breaks: Promoting movement breaks for all students
in the class throughout the day not only helps our kiddos, but every
student to regulate their neurological system.
Seating options that are not too expensive and easy to
try: move-n-sit cushion, disco sit, rocking chair, beanbag chair and a
clipboard for writing. Works well for students who seek movement and
have difficulty remaining seated during instruction.
Deep Breathing & Yoga: This helps the students to calm down and
works on stretching their muscles and core muscle strength.
Sugarless Chewing Gum: It provides proprioceptive input . A great
tool for focus and writing!
Quiet Classroom Corner
Any child in the classroom can use it, which makes the child who
needs it most not feel singled out. Once these kids get into the habit
of sitting in the beanbag reading corner or working at the study carrel,
they start to ask permission to go.