Special Education Compliance
School Based Occupational and Physical Therapy Services
Frequently Asked Questions
Recent Questions
- Who can provide occupational and physical therapy services? Posted 01/05/2004
- Can a paraprofessional or aide provide the designated occupational or physical therapy services as indicated on the IEP? Posted 01/05/2004
- Can occupational therapy assistants and licensed physical therapist assistants delegate tasks or activities to be implemented and provide supervision to paraprofessionals? Posted 01/05/2004
- Who can provide “motor services?” Posted 01/05/2004
- Can occupational therapy or physical therapy be provided to a child who is not eligible under IDEA but is eligible under Section 504? Posted 01/05/2004
- Does the concept of LRE in the federal law apply to the provision of OT and PT services too? Posted 01/05/2004
- Can physicians and outside service providers who are working with a child make specific recommendations for therapy services in the school environment? Posted 01/05/2004
- Should a child receive therapy because he/she will benefit from therapy even though no educational need exists? Posted 01/05/2004
- If the IEP team determines that a child with an orthopedic impairment or other health impairment requires only adapted physical education as special instruction, can the child receive occupational and physical therapy? Posted 01/05/2004
- How does a child become eligible for occupational or physical therapy? Posted 01/05/2004
- Is it necessary that every child who has been assessed and determined to need help in fine and gross motor skills receive occupational therapy or physical therapy? Posted 01/05/2004
- Who determines the type of service provision that the child will receive? Posted 01/05/2004
- Is an OT/PT evaluation needed prior to providing occupational or physical therapy respectively? Posted 01/05/2004
- If the OT is in the classroom doing integrated therapies, how is this documented on the IEP? Posted 01/05/2004
- When parents request to have their child receive a particular treatment technique or methodology such as sensory integration, how should the school administrator respond? Posted 01/05/2004
Questions & Answers
1. Who can provide occupational and physical therapy services? Posted 01/05/2004
Only a licensed occupational therapist or occupational therapy assistant under the supervision of an occupational therapist provides occupational therapy services. Only a licensed physical therapist or physical therapist assistant under the supervision of a physical therapist provides physical therapy services. Other professionals may, at the discretion of the therapist, implement activities to support the physical or occupational therapy following training by the occupational or physical therapist. Consultation and ongoing monitoring by the therapist is necessary under all circumstances where other personnel are utilized.
2. Can a paraprofessional or aide provide the designated occupational or physical therapy services as indicated on the IEP? Posted 01/05/2004
No. The minutes recorded as therapy on the IEP can only be provided by the licensed occupational or physical therapy practitioners (occupational therapist, occupational therapist assistant, physical therapist, physical therapist assistant).
3. Can occupational therapy assistants and licensed physical therapist assistants delegate tasks or activities to be implemented and provide supervision to paraprofessionals? Posted 01/05/2004
Yes. Under the supervision of the occupational and physical therapist who holds ultimate responsibility.
4. Who can provide “motor services?” Posted 01/05/2004
Neither Federal nor State Regulations include a definition of motor services. Some districts use terms such as motor services interchangeably with OT and PT, but the requirement is that if the IEP states OT or PT those services must be provided by the OT, OTA, PT or PTA respectively.
5. Can occupational therapy or physical therapy be provided to a child who is not eligible under IDEA but is eligible under Section 504? Posted 01/05/2004
Yes. In some cases this may be appropriate. The services are provided to a child who qualifies under Section 504 who may have a medical condition that impacts school performance. For example, a student with juvenile rheumatoid arthritis may be found ineligible for special education because a comprehensive educational evaluation did not indicate that the student was in need of special education. Under Section 504, this student may need assistance or adaptations to receive a free appropriate public education (FAPE) and the responsible public agency may determine those service needs to be provided by an OT or PT.
6. Does the concept of LRE in the federal law apply to the provision of OT and PT services too? Posted 01/05/2004
Yes. The Individuals with Disabilities Education Act (IDEA) specifies that special classes, separate schooling or other removal of children with disabilities from the regular educational environment occurs only if the nature or severity of the disability is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily. Related services are included in this requirement. Providing services to children in the general education environment helps ensure that the skill is generalized to that setting.
7. Can physicians and outside service providers who are working with a child make specific recommendations for therapy services in the school environment? Posted 01/05/2004
Yes. Recommendations may be submitted and responsible public agencies must consider this information, however are not bound to accept or implement the recommendations. Neither are districts required to conduct an IEP meeting to consider the information unless the parent requests an IEP meeting to do so. If, however, either the responsible public agency or parent believes the information is significant to a student’s special education services, an IEP meeting should be conducted and consideration given to changes to the IEP, if determined necessary.
8. Should a child receive therapy because he/she will benefit from therapy even though no educational need exists? Posted 01/05/2004
No. According to IDEA Part B, a child is only eligible for therapy services in order to benefit from special education.
9. If the IEP team determines that a child with an orthopedic impairment or other health impairment requires only adapted physical education as special instruction, can the child receive occupational and physical therapy? Posted 01/05/2004
Yes. Adapted physical education is considered special education. If the IEP team determines the student requires occupational and/or physical therapy to benefit from adapted physical education, then the child may receive the related service of occupational or physical therapy. Therapy must relate to the goals and objectives in the child’s IEP.
10. How does a child become eligible for occupational or physical therapy? Posted 01/05/2004
A child does not become eligible for occupational or physical therapy. The child becomes eligible for special education. There is no specific test or assessment tool that determines eligibility for OT or PT. The information from the evaluation report assists the IEP team in determining the need for occupational or physical therapy in order for the student to achieve his/her educational goals.
11. Is it necessary that every child who has been assessed and determined to need help in fine and gross motor skills receive occupational therapy or physical therapy? Posted 01/05/2004
No. The IEP team determines the services, level of services, and specialists required to support the educational needs of the child. In some cases, the general or special education program can address the motor needs of the child without additional support from occupational or physical therapy.
12. Who determines the type of service provision that the child will receive? Posted 01/05/2004
The IEP team determines the manner of providing the services that the child needs to meet his/her educational needs (direct, consultation, etc.). Evaluation results and recommendations from the licensed OT/PT should be carefully considered in the context of the child’s educational goals.
13. Is an OT/PT evaluation needed prior to providing occupational or physical therapy respectively? Posted 01/05/2004
Yes, if occupational and/or physical therapy will be related services on the IEP, a licensed OT and/or PT, as appropriate, will need to provide an assessment before occupational or physical therapy are provided to the child. This process may or may not involve the use of a formal assessment instrument. In some cases a physician’s prescription is required before the therapist evaluates the child.
14. If the OT is in the classroom doing integrated therapies, how is this documented on the IEP? Posted 01/05/2004
The amount of time and frequency determined necessary for the OT for the child is documented as Occupational Therapy and the location is shown as the classroom where the therapy is being provided. There is no need to use the term “integrated”. It is important to keep the documentation as clear and easy to understand for parents and all IEP team members as possible.
15. When parents request to have their child receive a particular treatment technique or methodology such as sensory integration, how should the school administrator respond? Posted 01/05/2004
Sensory integration and other treatment methodologies such as neurodevelopmental treatment (NDT) are just particular frames of reference or treatment perspectives which might be used by an OT or PT in the intervention process. The services that the schools are mandated to deliver are occupational or physical therapy and not a particular treatment regimen. In the schools, the focus of occupational and physical therapy is on the child’s ability to function in the educational environment. As long as the child’s educational needs are being appropriately met, the school based OT/PT is operating within their scope of practice and training. Therapists use their professional judgment, evaluation data, and expected outcomes to select the particular frame of reference which will guide the intervention.