• 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).

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.

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)

• 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.

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.