The decision of whether a child with a disability qualifies for school physical therapy is made by a ARD committee. This ARD committee determines whether the student has a disability, that indicates the need for special education, and requires related services such as physical therapy.
Physical therapy interventions are designed to enable the student to travel throughout the school environment; participate in classroom activities; maintain and change positions in the classroom; as well as manage stairs, restrooms, and the cafeteria when appropriate
School Based Therapy Frequently Asked Questions:
- Who may provide OT and/or PT?
Only a licensed OT including licensed OTAs under the supervision of an OT may provide therapy. Other educational professionals and paraprofessionals, such as instructional assistants may, at the discretion of an OT or PT, carry on the recommended activities following training by the OT or PT. Consultation and monitoring by an OT or PT is necessary under all circumstances.
- When is a referral for an OT assessment appropriate?
A referral for OT is appropriate when a student is not able to participate in the educational curriculum at the expected level of ability, when modifications and accommodations have not been effective, and when the areas of concern are in the domain of OT practice.
- Does an assessment to determine the need for OT need to be completed by a licensed OT?
Yes. No other service provider possesses the same licensing, qualifications, educational background, or training. Note: A PT may conduct an assessment in accordance with the referral without a specific medical diagnosis. Although a referral for PT can come from many sources, a PT cannot perform treatment intervention without a diagnosis from a physician or other duly licensed practitioner.
- If it has been determined by a physician or an outside agency that a student may benefit from OT, is the LEA responsible for providing these services?
No. However, an ARD meeting should be held to review the outside report and determine if additional supports and/or services are necessary for the child to benefit from his/her educational program. Whenever OT services are considered, those professionals with the qualifications should attend the ARD meeting. The ARD committee in the LEA must determine whether the student requires occupational therapy or physical therapy in order to benefit from the instructional program. The LEA is not responsible for OT and/or PT unless it can be demonstrated that the child has an educationally related need that only OT or PT (or both) can address.
- Do OT assessments determine that the child meets eligibility as an individual with exceptional needs?
No. The need for OT and/or PT alone does not make a student (based on the eligibility criteria) qualified to be considered an individual with exceptional needs. The ARD committee determines eligibility for special education on the basis of assessments in all areas of a suspected of disability.
- When does a child receive OT as a related service?
The ARD committee determines that OT services are included as a related service when assessment results show an educational need that only OT can address. A student’s diagnosis or disability alone does not indicate a need for therapy. However, the team considers the potential impact of the disability on the student’s education.
- How are the amount and mode of therapy service provision determined?
If the student is determined eligible as an individual with exceptional needs, goals are developed. The ARD committee determines which team member(s) has the expertise to achieve desired outcomes. If it is determined that OT is appropriate to meet the identified goal, the OT, based on professional frameworks, determines the methodology, intensity, and frequency of therapy required for the student to meet the identified IEP goal(s). OT or PT or both services may include direct services (individual or small group or integrative services) and/or a consultation to the ARD committee.
- If a child is receiving medically necessary therapy from outside agency, may he or she also receive therapy from the LEA?
Yes, a child may receive OT from an outside agency such as Children’s Hospital and still qualify for OT as a related service through the LEA if therapy is educationally necessary (2 CCR § 60325(e) and (f)).
- Why does an LEA determine whether therapy is educationally necessary or medically necessary?
The federal regulations do not differentiate between medically necessary and educationally necessary therapy. The law mandates that a referral to the LEA for an assessment of gross and fine motor skills shall be considered by either the LEA or by outside agency, depending on the information contained in the referral and the student’s documented physical, cognitive & perceptual functioning will determine the student’s need for medical or educational based assessment/treatment.
- Is it necessary that each child who has been assessed and determined to need help in gross and fine motor skills development receive occupational therapy, physical therapy, or adapted physical education from a specialist?
No, not every child with gross motor and fine motor needs will require special services. The ARD committee makes the determination of the appropriate strategies and services based upon the identified needs of the student. In some cases, the general education or special education program can meet the student’s needs. In other cases, students will need direct services or consultation (or both).
- What is the responsibility of the OT in providing services in an Extended School Year?
Extended School Year (ESY) services are defined as special education and related services that are provided to a student with a disability beyond the normal school year in accordance with the student’s ARD committee and as a necessary part of a free appropriate public education (34 CFR § 300.309(b)). The determination of whether a child requires an extended school year and OT and/or PT during an extended school year is made on an individual basis. If the ARD committee can show, on an individual basis, by using IDEA Part B procedures for evaluation, IEP development, and placement, that the student does not require the recommended OT, PT, or AT to receive FAPE, then the district does not have to provide the requested service. However, ARD committee should document that it discussed the independent evaluator’s report and recommendations. The ARD committee should also document why the services recommended are not necessary to provide the child with FAPE (McEwen 2000).