What parents need to know about occupational therapy in the school setting

By:  Dr. Tiffany G. Showalter, OTD, OTR/L

An occupational therapist or OT is a highly trained medical professional who evaluates and treats individuals of any age who have problems engaging in meaningful activities or “occupations” relevant to their everyday lives.  I can’t tell you how many times I have told someone that I am an OT and they want to know about getting someone a job.  In this economy, wouldn’t that be nice if I could get everyone a job?  The “occupation” in occupational therapy actually comes from the word occupy, and means any activity that “occupies” a person’s time.  This may include self-care, play and leisure activities, in addition to, work.  For a child, their job or occupation often involves playing, learning, and going to school.

Children make up a large part of the population receiving OT services and these services may be in the medical clinic setting or in the educational setting.  Not only are the settings different, but the priorities of each are quite different.  There are many children who require medically driven therapy services to participate in their relevant occupations and they can be referred for these services by a physician.  In the schools, children who have a medical need for therapy may or may not require therapy for an educational need. Additionally, a physician’s referral is not required nor does it determine need or amount of services provided.  OT in the school setting supports the student in meeting his/her educational goals; therefore, the level of OT support is driven by the student’s IEP. Educationally relevant therapy services may be indicated if the expertise and knowledge of the skilled professional (OT) is required for the student to meet their established educational goals and objectives.  It is important to understand these differences and why the goals are specific for outcomes related to the setting for which the student participates.

What is educational or school-based OT?

Educational or school-based OT is designed to enhance the student’s ability to fully access and be successful in the learning environment.  This might include:

• working on handwriting or fine motor skills so the student can complete written assignments
• addressing oral motor or swallowing concerns for eating while at school
• helping the student organize himself or herself in the environment so that he/she can attend to activities appropriately and follow directions
• working with the teacher to modify the classroom
• adapting learning materials to facilitate successful participation within the school.

School therapy is provided in the natural school environment, meaning treatment and/or evaluation may take place in the classroom, library, cafeteria, playground, or other designated area within the school.

How do I get OT for my child?

Occupational therapy (OT) is considered a related service under Part B of the Individuals with Disabilities Education Improvement Act of 2004 (IDEA), and is provided to help students with disabilities to benefit from special education.  As such, OT is a supportive service.  If your child has a disability, as defined by IDEA, and needs special education and related services to meet their unique learning needs, then he/she might require an OT evaluation or services.

How are therapy services determined?

An OT will evaluate the student using both informal and formalized assessments.  They will also review the student’s current IEP, interview teachers and staff working with the student, review work samples, and/or observe in different school settings.  After completing the evaluation, they will then present the findings to the IEP team.  Next, the IEP team determines whether OT support is educationally necessary based on the evaluation findings and the recommendations of the therapist.  Finally, the team determines the amount, frequency, and duration of OT services.  OT may be provided individually or in groups and may consist of direct treatment, consultation, or monitoring.  Consultation with teachers and school staff is an essential part of occupational therapy services.  By providing information and training, the educational staff can integrate the recommended strategies and techniques with the student everyday.

Who should I contact if I have concerns about my child which I feel may need addressed by OT?

The best place to start is with your child’s teacher.  However, you may also contact your county school system’s special education department or your school’s occupational therapist with your questions.  The American Association of Occupational Therapy is also a useful resource.

Disclaimer: I hope you enjoyed reading this article.  Please remember you are reading this information of your own free will and are taking the information at your own risk.  The author is the legal copyright holder of this material it may not be used, reprinted, or published without my written consent.  This information is for entertainment and informational purposes only and is not intended to provide or circumvent medical, legal or other professional advice.

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