Occupational Therapy and Physical Therapy Services in the School

Occupational Therapy and Physical Therapy 

Services in the School 

Occupational and Physical Therapy are related services available in the school setting if a 

child qualifies for special education services through the Exceptional Children’s Program. 

Occupational Therapy and Physical Therapy must be educationally relevant. Unlike and OT 

or PT in a clinical or medical setting who identify and treat the motor deficits, a school therapist 

can only address those deficits that inhibit the child to benefit from his/her specially designed 

educational program or independence accessing the school environment. The need for therapy 

services is not determined by clinical diagnosis, low test scores, or other indication of a gross or 

fine motor deficit. Related services are selected because the team agrees that they can best 

support the IEP team generated educational goals. 

If there are not educational concerns that warrant special education services, then OT or PT 

services are not indicated. There are exceptions to this if a child has a genetic, neuromuscular, 

orthopedic or degenerative disorder. These children may not have cognitive impairments but 

have significant motor or visual impairments that affect their ability to access materials in the 

school, or to be safe and independent in the school environment. 

With children who are identified as Speech/Language impaired only, OT or PT services are 

not indicated, unless they can support the Speech/Language goals. This may apply to a child with 

significant apraxia or significant sensory processing difficulties. 

Occupational Therapy in the school setting looks at areas a child is not fully participating in 

such as: 

· Personal Care (feeding/lunchroom, toileting, clothing management, setup/cleanup) 

· Student Role/Interaction Skills ( managing classroom materials, general classroom skills, 

work behaviors/organization, social skills) 

· Learning/Process Skills (following directions, attention, initiation, visual perceptual 

skills) 

· Play (individual play skills, exploring new play ideas/opportunities, sharing materials, 

working in groups) 

· Community Integration/Work (fieldtrips, schoolrelated vocational training) 

· Graphic Communication (handwriting, keyboarding, drawing, artwork) 

Occupational therapists provide expertise in the areas of fine motor/visualmotor skills, visual 

perceptual skills, ocular motor skills, sensory processing/regulation, equipment 

adaptations/modification, assistive technology, vocational assessment, and selfhelp skills. 

Areas most often addressed by the Physical Therapist are: 

· Functional mobility/gait 

· Gross motor skills as they relate to safety and a child’s ability to participate with peers 

· Postural control/seating 

· Balance 

· Equipment and/or environment adaptations/modifications 

· Transfer skills

2 

Assessment 

There are many ways on OT or PT can evaluate/assess a child to help identify deficits and 

problems the child may be experiencing in the school. These can include: 

· Concerns of the teachers, parents, and other school personnel 

· Observation of the child in the classroom, lunchroom, art, PE, playground, etc. 

· Assessment of class work 

· Functional school assessments which look at a wide range of task performance skills 

needed in the school environment 

· Clinical Observation/Assessments that look at underlying performance components 

(muscle strength/tone, sensory, bilateral skills, gait, balance, postural control, 

shoulder/arm/hand control, etc.) 

· Standardized testing which can identify developmental level in relation to peers 

· Review of information/testing by other disciplines or outside therapists 

Determination for Services and/or Level of Services 

This is based on many factors such as: 

· Child’s eligibility for special education services with educational concerns 

· Deficits significantly impact child’s ability to benefit from his special education goals 

· Amount of difficulty a child has accessing school environment and materials 

· The ability of other personnel to carry out goals or manage fine motor/gross motor 

concerns 

· Overall progress rate over the term of the IEP 

· Whether continued skill development can be best met in the least restrictive environment 

through the classroom, adaptive PE, regular PE, home program, etc. 

· Behavior issues, medical issues, or other factors that may make therapy 

counterproductive 

· Previous attempts to improve the deficit have not been successful in other settings, and 

the unique expertise of a therapist is required to meet student’s needs 

· If the student has critical health or safety needs that warrant a therapist’s presence in the 

educational environment 

· If the therapist can provide/consult on adaptations and modifications in the environment 

IEP and Service Models 

After evaluation of the student and contribution of his strengths/weaknesses in regards to fine 

and gross motor areas, OT’s and PT’s collaborate with the team on the best way to address these 

areas. We strongly advocate looking at the child as a whole versus a child with “OT/PT issues”, 

or “fine motor/gross motor” problems. We are most effective when our services focus on 

inclusion (least restrictive environment), consultation, and serving the children through a 

collaborative IEP. If therapy services are warranted, they can be delivered in several ways: 

Direct: This can be done individually, in a small group, within the classroom, or any 

combination of this that would benefit the child most. This involves therapist contact with the 

child as well as other related services such as consultation, adaptations/modifications, preparing 

materials, collaborating with other team members, developing programs for the classroom or 

home, etc. The extent and frequency of services can vary and is dependent on many factors.

3 

Related Services Support Plan (RSSP): This is used for students with minimal therapy needs, 

and is a means to provide necessary support to other personnel working with the student without 

the need for an IEP goal page. It outlines what areas a therapist will support in the 

classroom/school environment, what classroom interventions that are delegated to classroom staff 

with related service support, and is used most often with children who need ongoing monitoring 

for adaptations or programs, prevention of deteriorating conditions, or monitoring of equipment. 

This can be needed on an ongoing basis or short term. 

Regarding Occupational Therapy services with a Sensory Processing or Sensory Integrative 

Emphasis 

As with other OT services, intervention with a sensory integrative emphasis can be provided 

only as it relates to the student’s school function and interferes with a child reaching his special 

education goals. A school OT can provide education regarding sensory processing and its impact 

on learning, strategies/modifications for the classroom/curriculum and school environment to 

help a child participate, and use of sensory modalities during treatment or in the class to enhance 

attention, etc. 

Union County Public Schools 

Occupational/Physical Therapy Departments 

7/09

Occupational Therapy and Physical Therapy Services in the School

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