Occupational Therapy

What's Required

Occupational Therapy

(i) Means services provided by a qualified occupational therapist; and (ii) Includes - (A) Improving, developing, or restoring functions impaired or lost through illness, injury, or deprivation; (B) Improving ability to perform tasks for independent functioning if functions are impaired or lost; and (C) Preventing, through early intervention, initial or further impairment or loss of function (§ 300.34, Federal Regulations).

"Occupational Therapy is the therapeutic use of everyday life activities (occupations) with individuals or groups, for the purpose of enhancing or enabling participating in roles, habits, and routines in home, school, work place community and other settings. Occupational therapy practitioners are concerned with the end result of participation and thus enable engagement through adaptations and modifications to the environment or objects within the environment when needed." (Occupational therapy practice framework: domain & process, 3rd Edition (2014). American Journal of Occupational Therapy (AJOT). 68 (Supplement 1). S44. 

What We Do

Referral Process

When a campus or parent concern arises for a student in special education that involves occupational performance or participation in motor, process or social interactions (AJOT, 2014, S.44) as they relate to the student's educational needs, the campus will consider whether a referral to occupational therapy is warranted. There are several circumstances under which a referral to occupational therapy may be generated.

1. Students may be currently receiving special education services and demonstrate a lack of progress on a goal in an area that may require the addition of occupational therapy in order to allow the student to make satisfactory progress on that goal. 
2. Students may move in to the district with occupational therapy as part of their individual education plan.
3. Students may be undergoing an initial full and individual evaluation to determine eligibility for special education and the assessment team identifies the need for information from occupational therapy to assist in making the eligibility determination.
4. It is determined at the Review of Existing Evaluation Data meeting that updated assessment from occupational therapy is needed.

1. For students currently receiving special education services:  The campus team will:

• Determine whether the Checklist for OT or PT Referral form indicates the need for an occupational therapy consult/evaluation.
  • If yes, generate a referral for an occupational therapy consult/evaluation utilizing the Request for Special Education Services form and email to Teddy Ott at ottt@ocisd.net. 
  • If no, move to the next step in the referral process as follows:

• Review the student's progress in the identified IEP Goals and Objectives.
• Use measurable data to determine if there are barriers limiting the student's progress in the identified goals and objectives or if there are additional areas of difficulty for the student not previously identified.
• Consider campus based supports, including the pre-referral intervention strategies that are available to campus personnel on the Katy intranet that may address the identified barrier or additional area of difficulty.
• When the school has tried the pre-referral intervention strategies for a period of 4-6 weeks, data shows that the strategies have not resulted in adequate improvement in performance, and the barriers limiting student progress involve performance skills in the areas of motor, process or social interaction, the campus team may request technical assistance from the campus occupational therapist.

• Technical assistance is requested on the Request for Special Education Services form.  The form is e-mailed to Teddy Ott at ottt@ocisd.net.
• Tech assists are often completed through consultation with the teacher and can be scheduled during the teacher's conference period with no student observation needed. Recommendations may be given that are general in nature; strategies suggested are those that could benefit a similar group of students and are not specific to the student receiving the tech assist. 
• In responding to the request for technical assistance the OT practitioner may do any or all of the following: 
  • Review information such as work samples, report cards, outside evaluations, district evaluations, teacher observations, and previously attempted strategies. 
  • Collaborate with the student's teacher(s) regarding the student's history and progress in relation to the identified educational concern.
  • Observe the student in the educational setting during the time and in the environment(s) where the problem(s) occurs.

• Upon completion of the technical assist:
  • If no additional support is indicated: The therapist will complete the HCDE OT/PT or MT Documentation of Technical Assistance or Consultation Services form describing any observations/considerations and suggestions or follow-up that are recommended, review this information with the instructional team, and provide this form to the campus diagnostician or speech therapist to file in the state folder.
  • If an occupational therapy evaluation is indicated: The therapist will complete the HCDE OT/PT or MT Documentation of Technical Assistance or Consultation Services form recommending an occupational therapy consult/evaluation. The campus will follow steps to procure parent permission for a consult/evaluation.

2. For students who move into the district with occupational therapy as part of their  individual education plan:

• The Diagnostic Specialist will notify the therapist(s) of the move-in utilizing the Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net.
• The student will be ARDed for 30 school days according to the provisions in the IEP from the previous school district. 
• The therapist will use this time to collect data needed to determine recommendations for occupational therapy services in the new setting.   
• Please Note:  Due to the Texas OT licensure rules that govern occupational therapy practice, the therapist must have the following in order to provide occupational therapy services:
  • a current evaluation in hand (accurate/within last 3 years)
  • goals that indicate OT support
  • OT time, frequency and duration specified on the services page
  • for students with a medical condition (as defined in Texas OT Rule), a physician referral. 

Without these, the therapist can only provide general technical assistance.  If a current and adequate OT evaluation does not come with the student's paperwork, please request and hold a REED to obtain parent permission for an OT consult/evaluation.

3. For students who are currently undergoing a full and individual evaluation to determine eligibility for special education:

• On occasion, the evaluation team may determine that information from occupational therapy is needed in order to assist the team with making the eligibility determination.
• If it is determined that occupational therapy is needed to participate in the initial full and individual evaluation, the diagnostic specialist or speech therapist will send a referral to occupational therapy utilizing the Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net

4.  For students who are undergoing a re-evaluation process and it is determined that an updated occupational therapy evaluation is needed:

• The diagnostic specialist or speech therapist will procure parent permission for an occupational therapy consult/evaluation and send a referral to occupational therapy utilizing the Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net.

Evaluation Process

Occupational Therapy evaluation is a process "focused on finding out what a client wants and needs to do; determining what a client can do and has done; and identifying supports and barriers to health, well-being and participation. The evaluation consists of the occupational profile and an analysis of occupational performance."(AJOT, 2014, p.S13).

Service Delivery Models

• Student specific services are provided in an integrated model to facilitate the implementation of the individualized educational program (IEP) in the natural environment at school (including classrooms, hallways, cafeterias, gym, playground, etc.) Student specific OT services are available for all students receiving special education services if an educational need is identified by the ARD Committee. OT services are provided as an integrated support. Integrated OT service time may be used to work with the student in the classroom or other school environments to determine appropriate strategies, interventions and adapted equipment, and to train instructional staff on how and when to use strategies, interventions and adapted equipment. The OT provider will participate with the collaborative team on the campus to assess the effectiveness of interventions and to revise/adapt interventions as needed. 
• Technical assistance may be provided to students who are in either special education or general education. Technical assistance is provided in the form of general recommendations for instructional strategies that may benefit groups of students with needs similar to the student for whom technical assistance is being requested.
• An occupational therapist is assigned to each campus in Ore City ISD and is available as a campus resource.