Special Populations
Occupational Therapy and Physical Therapy in the Educational Setting
Introduction
Federal and state legislation ensure for all children with disabilities a free and appropriate public education, which includes special education and related services designed to meet their unique needs. As a result, the related services of occupational therapy and physical therapy were integrated into the educational environment in Louisiana’s public schools as early as 1978.
In the delivery of occupational therapy and physical therapy services, systems and therapists must be cognizant that these school-based services are not intended to replace the primary therapy students receive in medical and rehabilitation settings. Therapy is provided by the school system only when the student needs the service to benefit from special education instruction. The direct supportive relationship of the child's therapy needs and education must be clearly evident within the context of the pupil appraisal integrated report and the individual education plan (IEP).
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To assist local systems and therapists strengthen educational relationships, the Department of Education, Division of Special Populations published the Reference Handbook for Occupational Therapy and Physical Therapy in the Schools. Recent developments occurring in these professions and in the State of Louisiana are included in this edition.
Occupational Therapy and Physical Therapy in the Schools
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Eligibility Criteria for Services
The Criteria of Eligibility for Occupational Therapy and the Criteria of Eligibility for Physical Therapy were officially promulgated by the SBESE on December 17, 1987. These criteria were used by all therapists throughout the state to assist in determining whether a student needs occupational therapy or physical therapy intervention in the school setting. In 1998 the criteria were revised by a State-appointed task force of occupational and physical therapists. The task force made revisions in the outdated terminology and incorporated a new section to address the needs of students with sensorimotor impairments.
Use of Criteria
Upon completion of an occupational therapy or physical therapy assessment, the therapist uses the criteria to determine whether an exceptional student demonstrates/exhibits a need for occupational therapy or physical therapy in the school setting in order to benefit from his/her special education program. The therapist should keep in mind specific factors when using the criteria.
• The therapist should use the motor section, not the developmental delay section, with students who have medical diagnoses, such as spina bifida, muscular dystrophy, and cerebral palsy.
• When using the developmental criteria, the therapist should not average scores to determine the functional educational age; rather, he should view the gross or fine motor skill level in comparison to all other scores from other team members.
• Occupational therapists should use the sensorimotor section with students that exhibit an inability to integrate sensory stimuli effectively and whose capacity to perform functional activities within the educational setting is affected. Students evaluated for occupational therapy under the sensorimotor section should indicate an ability to improve functional activity performance through intervention.
• The criteria of eligibility initially determine the need for therapeutic intervention. They should not be used in the re-evaluation process.
The criteria for eligibility for occupational therapy and physical therapy can be found in the Pupil Appraisal Handbook, pages 101 through 111.
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Service Decisions
The decision regarding related services must be made in view of each student's unique needs. Sources of documentation can be the individual evaluation report and any subsequent evaluation reports submitted by therapists. The IEP team must consider each related service that is recommended on the evaluation report and document its decisions on the IEP form. For example, the team must:
1. list all services recommended by the team and the service provision schedules, dates, and location;
2. explain the team's decision not to include a recommended related service; and
3. explain delays in providing any related service listed on the IEP.
NOTE: This delay, or hardship, in no way relieves a system from providing the service and from documenting every effort to provide it in a timely manner.
The participation of related services personnel is extremely important during the IEP meeting. Involvement should be through either direct participation or written recommendations.
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