Occupational Therapy

Welcome to Occupational Therapy at Prospect Ridge Academy

School Based Occupational Therapy Services

(http://www.cde.state.co.us/cdesped/RS-OT.asp)

An occupational therapist is a trained health professional that uses purposeful, goal directed activities and task analysis to enable a child with a disability to benefit from their individualized education program (IEP).

Federal law mandates that occupational therapy (OT) in the school system be educationally relevant on the IEP. The focus of OT services in a school setting is to promote functional independence or participation within the educational environment. Educational OT services are those services developed by educational personnel and the family and authorized in a student's IEP. OT services may be delivered directly to the child, on behalf of the child (consultation with parents and teachers) or through modifications and support for school personnel that will be provided for the child (in-service training). The IEP team may determine that the student does not require occupational therapy through the educational program. OT services are not intended to satisfy the medical needs of a student and therefore may not meet the total therapy needs of the student. However, the student's family may wish to pursue therapy services outside the educational setting. The federal definition of occupational therapy as a related service, on the IEP, means services provided by a qualified occupational therapist; and includes-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; and preventing through early intervention, initial or further impairment or loss of function. [34 CFR 300.24(b) (5)]

Qualifications of a School Occupational Therapist

To work as an occupational therapist in Colorado's public schools, you must (a) maintain current certification by the National Board for Certification in Occupational Therapy (NBCOT), (b) be registered as an occupational therapist with the Department of Regulatory Agencies (DORA), and (c) have a Special Services License through the Colorado Department of Education (CDE).

Responsibilities of a School Occupational Therapist

In a school setting the OT may be involved by facilitating any or all of the following areas that may interfere with a child's educational performance during the identification process for an eligibility category in Special Education:

self-help skills (feeding, dressing, hygiene)
fine, gross and visual motor skills
sensory processing and visual processing skills
positioning, functional mobility and transitions
functional communication through alternative methods
adaptive devices/equipment & using educational tools/toys

See more at: http://www.cde.state.co.us/cdesped/RS-OT.asp#sthash.4XLsr3Dk.dpuf

Possible Indicators for Occupational Therapy

Poor hand use and tool use; extreme difficulty completing classroom activities requiring cutting, glue, manipulating small objects, pencil grasp, and handwriting
Has excessive difficulty in learning new motor tasks
Has difficulty with self-help skills necessary in the educational setting; feeding, toileting, hygiene managing fasteners and clothing.
Unable to maintain proper position for learning and functional use of both hands
Requires alternative means to accomplish functional activities; assistive technology
Extreme difficulty with sensory processing to textures, touch, visual, auditory, olfactory, and movement that substantially impedes ability to access the educational plan.

Service Delivery

Service Delivery Method	Description	Example
Direct	Service is provided in small groups or individually outside the general classroom. Hands-on methods are utilized when the emphasis is on acquiring new specific skills that cannot be safely or easily carried out in the student’s class setting or by others.	1) OT works with students in the therapy room to establish hand dominance and dexterity skills.
Integrated	Therapist provides interventions that occur in the natural environment within the school setting. Emphasis is on integration or generalization of the skills into actual school activities. Intervention is provided alongside peers.	1) During writing in class, OT works with the students using a slant board and modified paper. 2) OT works with students during lunch on obtaining food items.
Consultative	Therapist collaborates with special education teams, teachers/school staff and parents to develop and monitor intervention that can be carried out by others. Interventions may be in the form of specific classroom strategies, task modifications, home programs or environmental adaptations. It may also include staff training and providing additional resources. Consultation ensures carry-over of skills learned during direct and integrated methods.	1) OT suggests using a slant board for all writing activities. 2) OT suggests strategies for sensory Self-regulation (arousal levels) during reading. 3) OT trains staff in specific methods for self-help skills.

Resourced from NYC Department of Education, Fall 2011

Common Factors that Influence the Effectiveness of Therapy

Students age
Disability (type, degree, complications); impact on safety and function in school
Change in educational environment
Transitioning to a new team
Previous occupational therapy (rate of change)
Other assessment and intervention results
Previous IEP goals and objectives
Parent/family or caregiver input
Continuum of service options in school and community

Students recommended for occupational therapy services at various grade levels may require different forms of intervention. Younger students who typically demonstrate more potential for change may benefit from intense remediation of skills, while compensation via task and environmental modifications become more essential as the student gets older. Secondary students may have reached motoric capacity after a lengthy time period of service and may be considered for exit.

Colorado Department of Education Guidelines for Necessary Therapy Services

FUNCTIONAL AREA	SERVICES PROVIDED	RELATIONSHIP TO EDUCATION on the IEP
Self-help Skills Functional mobility Transitions	Functional mobility and transfer skills, feeding, toileting, adaptive equipment	To permit the child to manage personal needs within the school environment.
Adaptive Equipment	Recommend and modify or fabricate devices to facilitate fine motor and self-help skills.	Provide the child with alternative means to accomplish functional activities and independence.
Fine Motor/Visual Motor	Evaluate and improve functions such as reach, grasp, object manipulation, and dexterity	To facilitate the child’s ability to manipulate classroom tools (such as writing tools, art materials)
Sensory Supports	Activities which promote integration of tactile, visual, auditory, proprioceptive, and vestibular input	Accommodations using sensory based activities organized around a student’s daily schedule to achieve the goals, focus attention, and therefore to access and participation for the academic curriculum
Functional Communication	Accessing Assistive Technology (AT) devices	Positioning and method of accessing AT devices.

Colorado Department of Education (CDE guidelines)

Considerations for Grade Levels

	Preschool	Elementary School (K-5)	Middle School (6-8)	High School/Transition (9-12+)
Intervention Focus	Developmental approach, with intense remediation of skills.	Developmental approach, with intense remediation of skills. Increasing considerations for task and environmental adaptation as rate of acquisition of new skills slows with advancement in grade level.	Increased focus on task and environmental adaptations. Some remediation may be necessary for pre-vocational and ADL skills training. New skill acquisition slows or may plateau.	Mostly focused on task & environmental adaptations. Some remediation may be necessary for pre-vocational and ADL skills training.
Service Delivery Method	Mix of direct, integrated and consultative.	Mix of direct, integrated and consultative. K-2 is more direct for development of foundational skills. Gr. 3-5 more integrated and consultative for carry over and generalization of skills. Learning of compensations, and adaptations for independence.	More consultative to identify and implement adaptations to allow students to be as independent as possible.	Consultative to identify, implement and monitor adaptive equipment to accommodate student’s disability. Integrated if a student needs to acquire new skills while participating in pre-vocational and ADL programs.
Frequency	Generally weekly or bi- weekly to address developmental concerns affecting students’ schooling.	Generally weekly to address foundational skills that affect students schooling. Decreases in frequency as services move to consultative.	Monthly and bi weekly or semester depending on need for consultative and integrated methods.	Monthly and bi-weekly, semester, quarterly, yearly for consultative and integrated.
Examples	Direct 60-120 minutes -may be written per month or per week with team agreement	KG: Direct 1x per week for 30 min; focus on hand strength and manipulation skills for fine motor activities. 3rd gr. Student with CP; Integrated, 1x per week, 20 min; focus on managing lunchroom routine. Consultative 1x per month, 30 minutes for generalization of hand washing in various school environments.	6th gr. Student with ASD; consult 1x month, 20 min; provide strategies for sensory regulation due to new environment (some direct or integrated may be necessary for meaningful consultation).	12th gr. Student with moderate cognitive disability; consult 1x per month 30 min; focus on methods/strategies for meal preparation (some direct or integrated may be necessary for meaning consultation).

Individualized Educational Plan (IEP)

Occupational Therapists are responsible for assessing students to determine eligibility for services, and completing relevant documentation in the following areas: evaluation results, strengths/needs, present levels of performance, service delivery, goals, and accommodations/modifications.

Progress Reporting

Progress towards therapy objectives stated on IEP is to be completed and sent home quarterly, in alliance with the objective target dates stated on the IEP.