Occupational Therapy

Occupational Therapy Under IDEA

The Individuals with Disabilities Education Act (IDEA) Part B and the Connecticut General Statutes sections 10-76a to 10-76dd inclusive provide for the provision of special education for children with disabilities ages 3 through 21 “who, by reason thereof, need special education and related services.” Included are students with disabilities who have been suspended or expelled from school. Related services are “such developmental, corrective, and other supportive services . . . as required to assist a child with a disability to benefit from special education, and includes…occupational therapy.”[1]

Special education means “specially designed instruction” that meets the unique needs of students with disabilities. In addition to instruction in the classroom, special education includes instruction at home, in a hospital, and in other institutions; physical education; speech pathology (if considered special education instruction); and vocational education. Special education and related services are part of students’ individualized education programs (IEP), which detail the educational program tailored to meet students’ specific educational needs. According to case law, the IEP does not mean the best or maximum education possible, but should confer an educational benefit “likely to produce progress, not trivial education advancement.” In 1997 Congress reauthorized amendments to IDEA which cover numerous areas, such as: state and local educational agency role and responsibilities, eligibility criteria, student disciplinary situations, private/parochial/charter schools, parental involvement, IEP provisions, data collection, records, and grant funding.

What is Occupational Therapy?

Occupational Therapy (OT) is a related service for eligible students ages 3 through 21 who require “…such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education.”[2] This includes:

  • Improving, developing or restoring functions impaired or lost through illness, injury, or deprivation;
  • Improving ability to perform tasks for independent functioning when functions are impaired or lost;
  • Preventing, through early intervention, initial or further impairment or loss of function.[3]

What is the Purpose of Occupational Therapy?

Usually occupational therapy’s purpose is to help students:

  • Acquire and express sensory motor information;
  • Perform daily living activities required for school functioning and move through the school environment;
  • Assume student functions, which include:
  • Campus/school mobility,
  • Participating on a regular and timely basis,
  • Mental storage of material,
  • Recording information,
  • Studying,
  • Using tools and supplies,
  • Participating in activities throughout school settings.

School personnel commonly request occupational therapy support when students have difficulty with the following functions as related to educational participation:

  • Daily living activities (ADL);
  • Feeding and oral function;
  • Play skills;
  • Task organization and completion;
  • Written communication skills and hand function;
  • Sensory integration (processing);
  • Visual perception.

Who is eligible for Occupational Therapy?

In order for students to receive OT services under IDEA Part B, federal law requires that the students be eligible for special education and that the related service be necessary to assist the students with disabilities to benefit from special education. In this manner, OTs serve in a supportive role, helping students participate in and benefit from special education. Occupational therapy is defined as service provided by a qualified occupational therapist.[4]

Eligibility covers children with disabilities in any of the following federal classifications who may have a need for occupational therapy as a related service:

  • Mental retardation;
  • Hearing impairments, including deafness;
  • Speech or language impairments;
  • Visual impairments, including blindness;
  • Serious emotional disturbance; orthopedic impairments;
  • Autism;
  • Traumatic brain injury;
  • Other health impairments;
  • Specific learning disabilities;
  • Deaf-blindness/multiple disabilities;
  • Neurological impairment;
  • Developmental delays (3-5 years).

Who refers my child for Occupational Therapy?

The LEA may make referrals for occupational therapy (OT) services when students demonstrate educationally-related dysfunction in:

  • Performance areas of self-help or adaptive skills, work, and productive activities;
  • Play or leisure activities;
  • Performance components of sensorimotor, cognitive, and psycho-social development that may affect the learning process.

Since referral procedures vary among school systems, therapists should become thoroughly familiar with the process in their assigned school(s). Many schools have an established referral protocol, which may include pre-referral, identification of problems(s), accepted strategies, and work samples. The teacher, school psychologist, physician, other related services personnel, community agencies providers, or parents may initiate referrals in the educational setting. Best practice is that collaboration remains the foundation for all procedures. Referral information should include:

  • the screening (if done) and records;
  • interviews with parents, school personnel and related professionals; and
  • work samples, where relevant.

Will I have to pay for Occupational Therapy Services?

No, Required Services for students with disabilities include a free appropriate public education (FAPE). This means special education and related services provided at public expense, under public supervision and direction, and without charge, which meet the state standards. Preschool, elementary or secondary school education is provided in conformity with students’ IEPs. Services include:

  • Special education;
  • Related services needed by students to benefit from special education means transportation and such developmental, corrective, and other related/supportive services including:
  • Speech pathology and audiology,
  • Psychological services,
  • Physical and occupational therapy,
  • Recreation, including therapeutic recreation,
  • Social work services,
  • Counseling services,
  • Medical services (diagnostic or evaluation only),
  • Parent training and counseling,
  • Assistive technology devices and services,
  • Rehabilitation counseling, and
  • School health services.

Occupational Therapy Under Section 504 of the Rehabilitation Act of 1973

Section 504 of the Rehabilitation Act is a broad civil rights law, which protects the rights of individuals with disabilities in programs, and activities that receive federal financial assistance from the U.S. Department of Education. Section 504 requires an accommodation plan for all students who meet the definition of disabled. General education is responsible for providing equal access to all programs operated by the public school to students with disabilities under the requirements of Section 504. Sometimes students with disabilities are not eligible for special education services yet have difficulty participating in and benefiting from educational programs. The occupational therapist can have varying roles in meeting the needs of students who qualify for services under section 504 or the ADA including:

  • Providing assistance in environmental adaptations;
  • Acquiring or modifying equipment or devices;
  • Helping develop the written educational accommodation plan;
  • Participating in the determination of 504 eligibility.

Any school that receives federal funds must modify or make substitutions in meals for students whose disabilities restrict their diet, such as providing blended foods, special diets, cafeteria modifications, or utensils, at no extra cost.  Under Section 504 of the Rehabilitation Act, students might be eligible for occupational therapy services as a reasonable accommodation to help them learn, care for themselves, perform manual tasks, walk, speak and breathe. Under Section 504, students who are currently disabled cannot be denied, or excluded from, educational services. The definition of disability in Section 504 is much broader than the disability categories specified in IDEA. Section 504 identifies individuals with disabilities if they have a physical or mental impairment which substantially limits a major life activity, have a record of the impairment, or are regarded as having such an impairment. Students with disabilities defined under 504 must have equal access to educational services as non-disabled students.[5]

[1] 34 C.F.R 300.16.
[2] 34 CFR 300.16(a).
[3] 300.16(5)(i)(ii)(iii).
[4] 34CFR 300.16 (a)(7).
[5] State of Connecticut, Department of Education, Guidelines for Occupational Therapy in Educational Settings (1999) http://www.sde.ct.gov/sde/lib/sde/PDF/DEPS/Special/OTGuidelines.pdf.

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