Name: Susan Smith, M.ED.
Title: Director, Exceptional Student Services
Phone number: (928) 527-6171

Name: Michele Moore
Title: Account Specialist, Exceptional Student Services
Email Address: mmoore@fusd1.org 
Phone number: (928) 527-6160

Who can get school-based therapy services? 

• OT/PT is a related service, not a stand-alone service.
• Student must be identified as having a disability that interferes with education under the criteria of IDEA.
• OT/PT is not based on specific test scores or discrepancies, but rather on whether the unique expertise of the therapist is required for the student’s educational participation.
• Medical diagnosis itself does not determine eligibility under IDEA.
• The disability must “adversely affect the child's educational performance” (Part B).

What is the definition of school-based therapy services under Federal Law IDEA?

OCCUPATIONAL THERAPY

• 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

 PHYSICAL THERAPY

• Help a child with an educational disability benefit from his/her special education program in the least restrictive learning environment. Physical therapists address performance skills where a child’s disability impacts or compromises their ability to access, participate, and/or make progress in their natural learning environments.

What does school-based therapy work on?

OCCUPATIONAL THERAPY

• Fine motor deficits that impact academics
  • Fine motor dexterity (cutting, manipulatives, etc.)
  • Posture or seating if physical therapy is not involved
  • Imitating motor movements (circle time, fingerplays)
  • Bilateral coordination (using two hands to do two different things)
• Visual Perceptual deficits that impact academics
  • Handwriting (fundamental motor skills related to handwriting – after formal instruction)
  • Letter formation
  • Sizing
  • Spacing
  • Typing
  • Visual sequencing (puzzles, etc.)
  • Figure ground (finding items in a competing background)
• Sensory-based behaviors that impact academics
  • Oversensitivity
    • Student squints, covers ears, refuses messy play
  • Overstimulation
    • “Shuts down” when the environment is too noisy or busy
  • Seeking movement
    • Getting up out of seat frequently, frenetic movement
  • Seeking pressure
    • Sitting on feet, touching others excessively, crashing into things

 PHYSICAL THERAPY

• Gross motor deficits that impact academics
• Posture and positioning—Symmetry of positions, handling and transfer methods
• Neuromuscular and musculoskeletal systems—Range of motion, control of muscle tone, muscle strength, endurance, gross motor coordination, and motor planning
• Sensory processing—Equilibrium and protective reactions, proprioceptive and kinesthetic input, and bilateral coordination
• Functional communication—Classroom positioning, recommendations for adaptive devices or equipment
• Environmental adaptations—Evaluations and recommendations for modifications of architectural barriers and children’s equipment
• Adaptive equipment—Skin care, recommendations for splints, bracing, and positioning devices
• Functional mobility—Transfer skills, gait evaluation and recommendations, wheelchair mobility
• Mobility and transfer skills—Adaptive equipment, wheelchair and equipment care, and use for self-help
• Physiological function—Functional muscle strengthening, cardiorespiratory function and fitness, body mechanics, energy conservation techniques
• Prevocational and vocational skills—Generally strengthening, sitting and standing tolerance, motor coordination, adaptive equipment
• Education/communication—Information on disability and educational impact, staff training and development, liaison between medical and education staff (Martin, 1992)

What is not is an OT/PT’s realm of practice?

• Writing conventions
  • Capitalization and punctuation
  • Grammar
  • Content
• Attention-seeking or escape behaviors
  • Behaviors that can be remediated with a positive behavior plan, sticker chart, etc.
• Students may have a diagnosed disability that impacts their motor skills BUT if it is not impacting their ability to participate in the educational program, then school-based related services are not indicated.

 PHYSICAL THERAPY

• Personal trainer
  • Weight loss specialist/sports motivator
• “Toe Walking”
  • How is this adversely impacting student’s education?
• Acute orthopedic injuries
• Students may have a diagnosed disability that impacts their motor skills BUT if it is not impacting their ability to participate in the educational program, then school-based related services are not indicated.

When are school-based therapy services discontinued?  

Discontinuing PT/OT services is warranted when the IEP/504 team determines that the child no longer requires the unique expertise of the occupational/physical therapist to achieve educational benefit. Factors in this decision include:

• Child has met the functional goals.
• Deficits are no longer interfering with the child’s ability to function within his/her educational program.
• Strategies can be implemented by the current educational team.
• Equipment and environmental modifications are in place and are effective.
• Level of participation is within expectation for the child’s educational program.