Related services are a support that all students with disabilities have a FAPE with education services designed to meet specific individual educational needs. To qualify for related services, the student must show an educational related difficulty which impairs his/her ability to function in the school environment. Occupational therapy and physical therapy are considered related services.
Occupational therapy (OT) is a related service under Part B of the Individuals Disabilities Act (IDEA) and is provided to support the IEP for students who have a disability that interferes with their ability to access their educational program. School based occupational therapists work as part of the IEP team to promote function and participation in the school setting. “School occupational therapists (and occupational therapy assistants, under the supervision of the occupational therapist) support academic and non-academic outcomes, including social skills, math, reading and writing (i.e., literacy), behavior management, recess, participation in sports, self-help skills, prevocational/ vocational participation, transportation, and more. Because of their expertise in activity and environmental analysis, practitioners are particularly skilled in facilitating student access to curricular and extracurricular activities. They focus on the students’ strengths, and can design and implement programming to improve inclusion and accessibility, such as Universal Design for Learning.”
- Services provided by a qualified occupational therapist or assistant
- Improving, developing or restoring functions impaired or lost through illness, injury or deprivation
- Improving ability to perform tasks for independent functioning if functions are impaired or lost
- preventing, through early intervention, initial or further impairment or loss of function
- Occupational therapy services in schools may include:
- self-help skills or adaptive living (eating, dressing)
- functional mobility (moving through the school)
- positioning (sitting appropriately in class)
- sensory-motor processing (using the senses and muscles)
- fine motor (writing and cutting) and gross motor performance (walking and athletic skills)
- life skills training/vocational skills
- psychosocial adaptation
Physical therapy (PT) is a related service under Part B of the Individuals Disabilities Act (IDEA) and is provided to support the IEP for students who have a disability that interferes with their ability to access their educational program. School based physical therapists work as part of the IEP team to promote function and participation in the school setting. “Using their unique expertise in movement and function, PTs ensure a free and appropriate education for students with disabilities to prepare them for further education, employment, and independent living. The school-based PT promotes motor development and the student’s participation in everyday routines and activities that are a part of his or her program.“
- Services provided by a qualified physical therapist or assistant
- These services generally address a child’s posture, muscle strength, mobility and organization of movement in educational environments.
- PT may be provided to prevent the onset or progression of impairment, functional limitation, disability or changes in physical function or health resulting from injury, disease or other causes.
- Qualified PT providers may:
- provide treatment to increase mobility and endurance
- address gross motor skills involved in physical movements
- help improve the student’s posture, gait and body awareness
- monitor the function, fit and proper use of mobility aids and devices
- functional mobility
Once parental consent is obtained, a screening is completed to determine what is interfering with learning and access and to determine if an occupational therapy or physical therapy evaluation is warranted. The screening process includes observation of the student, review of student records, interviews with teachers and parents regarding the reason for referral, and completion of a screening document designed to identify problems that interfere with school function and participation.
Based on information gathered during the screening, if an evaluation is warranted, it is implemented in accordance with district policy and procedures. Assessment data is gathered from a variety of sources, including a review of existing evaluation data, formal and information evaluation, observation of student and interviews with student, teachers and parents. Once the evaluation has been completed, the therapist(s) use clinical judgment and evidence based decision making to determine if support from OT or PT as a related service is indicated. IF services are indicated, the evaluation is reviewed with the IEP team/ARD committee and submitted as record in the student’s permanent file. All determinations pertaining to eligibility, educational planning, placements, and services to be provided remain the sole responsibility of the IEP committee.
DELIVERY MODEL: Support from OT or PT as a related service can be direct or indirect, in class or pull-out using an integrated delivery model. The “integrated” service delivery model may be provided in all school environments e.g.: classroom, hallways, playground, cafeteria and bathroom. Indirect services also include, but are not limited to, staff training, home/school programs, contact with physician and/or equipment companies, contact with parent and equipment fabrication.
Under IDEA, OT and PT are considered related services. Related services are provided to children in special education to ensure the child is able to participate in the learning task. These services are to provide a child with equal opportunity that would not exist without therapy services. Legal mandates require the school based therapist deliver only those services necessary to assist the student in benefiting from their educational program not merely maximization of the child’s potential or remedy dysfunction. Discontinuation of services may occur when skills have been incorporated into school routines, when needed supports are in place without support from related service or when the student is not showing anticipated progress.
PROVISION OF SERVICES
Occupational therapy as a related service will be provided according to the TX OT Practice Act which states:
Treatment for a medical condition by an OT requires a referral from a licensed referral source. If a written referral signed by the licensed referral source is not received by the third treatment or within two weeks….. the therapist must exercise professional judgment to determine cessation or continuation of treatment….Non-medical conditions do not require a referral.
Physical therapy as a related service will be provided according to the TX PT Practice Act which states: The PT may provide general consultation or other PT program services to school…..educators….parents and others to address district, campus, classroom or student centered issues. For the student who is eligible to receive PT services as a related service in accordance with the student’s ARD committee reports….. types of services which may require a physician’s referral in the educational setting include the provision of individualized specially designed instructions and the direct physical modeling or hands-on demonstration of activities …..direct provision of activities which are such a nature that they are only conducted with an eligible student by a PT or PTA.
Students may be dismissed from therapy services based on the following dismissal criteria:
- the student’s level of educational functioning in the area(s) being addressed has reached age level, grade level and /or level of intellectual functioning.
- the student has developed the performance components needed to progress toward the educational goals established in the IEP.
- the areas of concern being addressed in the therapy do not interfere with the student’s ability to function or make progress in his educational setting.
- environmental or curricular adaptations have been established to allow for achievement of educational goals.
- the student’s needs for remediation in the area(s) being addressed are being fully met by the student’s educational or other service providers without the need for continued therapist contact.
For more information regarding OT/PT services, please contact:
Amanda Letsos, OTR
Kim Teter, Physical Therapist