Occupational Therapy Program Guidlines
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Definition of Occupational Therapy
Occupational therapy services are provided by a professional occupational therapist currently registered and certified nationally by the American Occupational Therapy Certification Board. Occupational therapy targets student performance in the educational setting and is defined as a related service or designated instruction and service that children eligible for special education may need to benefit from the education program. As defined by the law, "Occupational therapy" includes:

(i) improving ability to perform tasks for independent functioning when functions are impaired or lost; and (ii) preventing, through early intervention, initial or further impairment or loss of function.
(34 CFR 300.16[b)[51)

Role of the Occupational Therapist

1. Identification, Referral, and Request for Assessment: May participate in the initial screening, special education referral process or facilitate the assessment request process for OT services.
2. Assessment: Completes the educationally related or early intervention OT assessment, which includes student observation, record review, interview, standardized/nonstandardized testing procedures in areas of suspected disability according to specified timeliness Writes the assessment report and reassesses the student on an annual basis, or more frequently as requested by the IEP team.
3. Student Program Planning: Reviews the OT assessment findings and identifies student abilities and educational, developmental, or functional needs of the student with the IEP team. Develops goals and objectives for the IEP and coordinates the implementation of those goals/outcomes with the team to provide integrated services.
4. Intervention Planning and Implementation: Develops and implements therapy intervention plan that supports IEP goals and objectives which may include the adaptation or modification of the student's environment, materials, and curriculum if appropriate and classroom or home intervention strategies. Provides for pullout services only when more inclusive strategies are insufficient to meet the student's needs.
5. Documentation: Documents findings, actions taken, and/or recommendations regarding involvement in the special education process as specified by regulations, procedures and professional standards. RBDIS 10/98
6. Liaison: Communicates with all involved staff, coworkers, administration, students and parents to ensure timely and efficient service delivery as designated by the IEP. Complies with established confidentiality procedures regarding the release of Information process.
7. Staff Development: Develops and implements training opportunities and services for educational staff, parents and administrators. Attends and shares continuing education information with coworkers to foster professional growth and educationally related practice.

Referral for Occupational Therapy
A referral for an Occupational Therapy Assessment may be made by the parent, teacher or IEP team member. A Referral Form (see TU Referral Form 1.0) must be completed and submitted with a current copy of the IEP or SST checklist. All parent and school requests must be dated and forwarded promptly to the Occupational Therapy Department, 1995 Quintara Ave, in order to adhere to compliance time lines.

Occupational Therapy may be recommended when...

1. Difficulty in learning new motor tasks

2. Poor organization and sequencing of tasks

3. Poor hand use (including writing and tool use)

4. Difficulty in accomplishing tasks without the use of adaptive equipment, environmental modifications, or assistive technology

5. Unusual or limited play patterns

6. Deficits in adaptive self-help or feeding skills in the educational setting

7. Poor attention to task

8. Notable overreaction or underreaction to textures, touch, or movement

(taken from: Guidelines for Occupational Therapy & Physical Therapy in California Public Schools, California Department of Education, 1996)

Considerations
To receive occupational therapy as a designated instruction and service, the student must have an educationally disabling condition under IDEA. When referring students for an occupational therapy assessment, please carefully and routinely consider the following:

1. Prime Age: Therapy is more effective for children from birth through age of eight to ten years.

2. Acute Trauma: Therapy may be advisable for older children following an acute trauma which leads to a long-term disability.

3. Previous Therapy: Alternative programs should be considered for children who have received previous therapy.

4. Priorities: Education students should have their support services carefully prioritized for the maximum utilization of time spent in school.

Methods of Service Delivery
Designated instruction and services as specified in the individualized education program shall be available when the instruction and services are necessary for the pupil to benefit educationally from his or her instructional program. Instruction and services shall be provided by the regular class teacher, the special class teacher, or the resource specialist if the teacher or specialist Is competent to provide such instruction and services and if the provision of such instruction and services by the teacher or specialist Is feasible. If not, the appropriate designated Instruction and services specialist shall provide such instruction and services. Designated Instruction and services shall meet standards adopted by the board. (Education Code Section 56363)

Direct Therapy: Employs specific therapeutic techniques to remediate or prevent problems that are identified through the assessment process, adversely affect educational performance, and are based on program objectives developed by the multidisciplinary team. Occupational therapy personnel have frequent and consistent contact at least once a week; are responsible for planning, implementing and revising the occupational therapy program; and share responsibility for the IEP with other team members. Children can receive direct therapy individually or in small groups.

Monitoring: Employs collaborative teaming to teach and directly supervise other professionals or paraprofessional who are involved with the Implementation of intervention procedures. The occupational therapist completes an evaluation and develops an Intervention program to enhance the achievement of the IEP goals, but teaches someone else In the Immediate environment to carry out the procedures with the child. The therapist may not supervise all activities of these persons, but provides information and quality control in his or her areas of expertise. The therapist would continue to have contact on a regular basis ( at least once a month) to determine whether adjustments In the Intervention procedures are necessary. It is recommended that contact be made on site.

Consultation: Is a service in which the occupational therapist's expertise is used to help the education system achieve its goals and objectives. Case consultation focuses on the development of the most effective educational environment for children with special needs. Colleague consultation addresses the needs of other professionals In the educational environment system consultation addresses the needs of the system to maximize the use of its occupational therapy personnel and Improve the effectiveness of the whole system.

(taken from: Guidelines for Occupational Therapy Services in School Systems, The American Occupational Therapy Association, Inc, 1987)

Program Completion
The IEP team may consider the following conditions when determining that the student no longer needs occupational therapy to benefit from their educational program.

1. The student is functional within the educational environment, and therapy services are no longer indicated.

2. Other educational personnel are able to assist the student in areas of concern previously addressed by OT.

3. Student performance remains unchanged despite multiple efforts by the therapist to remediate the concerns or to assist the student in compensating.

4. The student continues to make progress in the areas being addressed by OT consistent with developmental progress in other educational areas despite a decrease in OT services.

5. Therapy is contraindicated because of the change in medical or physical status.