Providing Occupational Therapy, Physical Therapy, Speech Therapy and School Psychology services to Students in Schools and Government Agencies
Therapy services include consultation, evaluation, and development of Individualized Educational Plans (IEP), treatment, participation as an interdisciplinary team member during developmental assessments, participation in team meetings, in-services, and other services outlined by the Director of Special Education.
The therapists employed by Pediatric Therapies, Inc. have treated children with a variety of disabilities. Therapists will evaluate new referrals and present their findings to the eligibility or IEP team. Level of service will be determined by the team and then treatment will be provided as outlined in the IEP. The therapists will make all attempts to attend eligibility and IEP meetings on all of their students. If the therapists are not in the county on the day of a meeting, they will make sure all reports are in two days prior to the meeting and will discuss pertinent information with a team member prior to the meeting. Pediatric Therapies, Inc. puts a strong emphasis on IDEA guidelines and providing the appropriate educational therapy for a student so that they can optimally function within their classroom and are served in their least restrictive environment.
After consulting with the team and deciding where the student could most benefit from therapy, occupational or physical therapy may be provided within the classroom or on a pull-out basis utilizing some other space within the school that is appropriate for that student (i.e. playground, gym, cafeteria, art). The place where therapy will be provided can also change session to session based on the needs of the student or teacher. If the IEP team determines that home therapy is the least restrictive environment, the therapists and the Director of Special Education will determine the best way to provide the therapy. The therapist will provide IEP updates in accordance with the State and Federal requirements and guidelines.
Our therapists often work with other team members in weekly groups or special activities. Our therapists have worked together with teachers, aides, physical education teachers and other non-academic teachers, speech therapists, vision teachers, principals, and support staff. Therapists stress input from the teachers and aides, and consult with them to determine their needs with this student and how the student is doing within the classroom and the school.
All of the therapists employed by Pediatric Therapies, Inc. use an eclectic approach to direct therapy. This includes a combination of approaches such as sensory integration, neurodevelopmental treatment, and spatiotemporal adaptation. Therapy sessions are age-appropriate, fun, and use equipment and toys that are used by all students and not just for “therapy.” The emphasis for all treatment is to increase the function of the student within the educational environment. The student is also served indirectly by consulting with the personnel involved with them, educating staff about medical needs, and any other pertinent information. The therapists are more than willing to provide in-services to the staff.
School-Based Occupational and Physical Therapy Service Provision:
- Who Receives Occupational and Physical Therapy in Schools?
School based therapies are intended to support a student’s benefit from special education programming (specially designed instruction). Services are delivered in order to improve, develop, or restore functions impaired or lost through illness, injury, or deprivation; delivered in order to improve ability to perform tasks for independent function (including accommodating a disability); delivered in order to prevent further impairment of loss of function. Occupational therapy is a related service under Part B of the Invididuals with Disabilities Educations Act (IDEA), and is provided to help a student with a disability benefit from special education. Once a student is eligible for special education, that student then has access to all related services, including occupational and physical therapy. The educational team and the therapist must determine if therapy is necessary to support a student’s participation in curricular and extracurricular activities (IDEA; Giangreco, 1995).
In addition to IDEA, some students receive therapy services in order to access public education programs, services, and activities under Section 504 of the Rehabilitation Act of 1973. Under Section 504, a disabled student may be eligible to receive OT when a physical or mental impairment substantially limits one or more major life activities. Major life activities include caring for oneself, performing manual tasks, walking, talking, seeing, hearing, speaking, breathing, working and learning.
Occupational therapy services in schools are provided by qualified, licensed occupational therapists and occupational therapy assistants. Physical therapy services in schools are provided by qualified, licensed physical therapists or physical therapy assistants.
- Services Occupational and Physical Therapists Provide in Schools:
- Participate in the referral process
- Conduct evaluations
- Help determine eligibility
- Help create student goal plans
- Provide intervention
- Chart and communicate progress
- Re-evaluate
- Help determine need to terminate services
Often, a request for a therapy evaluation is made by the special education team. A referral is appropriate when a child is not able to participate in the educational curriculum at the expected level of ability, when modifications and accommodations have not been effective, and when the areas of concern are within the domain of OT or PT practice.
Occupational therapy practitioners are trained to assess and treat occupational performance problems in the context where their occupations are being done. Occupational therapy interventions are designed to help children with disabilities fully participate in school and social situations, including math, reading, writing, behavior management, self-help skills, prevocational/vocational skills, sports, and recess.
Physical therapy practitioners are trained to evaluate the child’s ability to move throughout the school environment and to participate in classroom activities. Physical therapy interventions are designed to enable the student to travel throughout the school environment; participate in classroom activities; maintain and change positions in the classroom; as well as manage stairs, restrooms, and the cafeteria. Test scores and standard deviations can be taken into consideration when making the decision to provide OT or PT as a support service, but they cannot be the sole determining factor. The therapist gathers relevant functional, developmental and academic information about the child to determine his or her needs through observation in various contexts, standard and non-standard measures, outcome tools and classroom assessments.
The OT and PT evaluation should describe the student’s:
- participation (engagement in life situations)
- activities (tasks)
- body functions (physiology)
- structures (anatomy)
- personal and environmental factors
School activities include:
- school mobility
- accessing bus
- fieldtrips
- cafeteria
- art
- music
- after school activities
- clubs
- managing materials
- emergency procedures
- self care.
Body functions include:
- posture
- balance
- strength
- muscle tone
- range of motion
- heart/respiration rate
- bowel and bladder control
Input from the child, the family and educational team is crucial. Focus is on finding what the child wants and needs to do, determining what the student can do, and identifying those factors that act as supports or barriers. When there is a discrepancy between the demand of the classroom task and the child’s actual performance, an intervention plan is developed to match the child’s capabilities and support the steps of this task in the particular environment and context.
OTs and PTs work collaboratively with the team to determine appropriate outcomes for students. The goals are participation based, aligned with the curriculum, address activities that happen in school every day, address the whole child and are not so specialized that teachers cannot implement.
OTs and PTs intervene by providing direct service (one-on-one or in groups), consultation, and monitoring based on the student’s goal plan. Services are provided in the least restrictive environment, which usually means integrating therapy into the student’s classroom schedule or daily routine. The therapist’s role may include environmental modification, staff education, curriculum modification and accommodations. When therapy is provided in the classroom it has been found that teachers and specialists consult with each other four times as much as when therapy is provided out of class (Louis Hutter-Pishgahi, 2004).
OTs and PTs document changes in the student’s performance and capacities and for transitioning the client to other types or intensity of service or discontinuing services when therapy no longer affects function in the school setting or the student demonstrates no potential for change or progress.