The purpose of School-Based Occupational Therapists is to help students succeed in performing all the tasks necessary for participation and learning at school. Schools provide occupational therapy when a child with a disability requires this related service to assist the child to benefit from special education. Occupational therapists use purposeful activity to facilitate a child's active participation in self-maintenance; academic and vocational pursuits; and play or leisure activities that occur in school environments. Using direct and indirect services, as well as assistive technology and environmental modifications, school occupational therapists collaborate with parents, teachers and other educational staff to help implement a child's special education program.
Occupational Therapy services are provided across a continuum and are determined by the Individual Education Plan (IEP) team. Based on these student's needs the Occupational Therapy service delivery model includes consultation with education team members and direct "hands on" intervention, individually or in groups.
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The provision of school-based therapy is governed by federal and state laws. Therapy is a related service to special education and is provided only if the student needs therapy to benefit from their special education program.
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Therapy is determined by the Individual Education Plan (IEP) team members. Parents are a part of this team. The team determines the amount, frequency and duration of therapy.
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Therapy may be provided individually or in groups by a therapist. Intervention may or may not be provided directly to the child. Collaborating with educational staff to modify the child's environment and daily school activities is always a part of school therapy.
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The decision to discontinue occupational therapy is made by the IEP team. This may occur when the student is no longer eligible for special education, when other members of the IEP Team can provide necessary interventions, or when the child can perform school tasks without therapeutic intervention.
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Eligibility Criteria for OT Services
In order to receive OT services, a student must demonstrate a clustering of delayed standardized test scores and/or delays in educationally related functional skills.
Functional Performance:
- Motor/Postural:Students must demonstrate significant difficulty maintaining functional positions and movements which support educational tasks.
- Fine motor/Upper body control:Students must demonstrate difficulty manipulating pencils or other age-appropriate tools, have muscle weakness, and/or have fine motor planning difficulties which impair fine motor performance.
- Sensory processing: Students must demonstrate impaired sensory processing which interferes with functional academic tasks and participation in the educational environment.
- Visual motor integration:Students must demonstrate delays in visual perception and fine motor performance that interferes with academic tasks such as handwriting and drawing.
In some instances, students whose disability affects their participation in school but who do not qualify under the Individuals with Disabilities Education Act (IDEA), may be eligible to receive occupational therapy under other federal laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act.
Dismissal Criteria for OT Services
OT service may be discontinued when any of the following occur:
- The student's performance is assessed to be within age expectation, based on the student's chronological age or is commensurate with cognitive abilities.
- The established goals have been met.
- There is a plateau in the student's performance.The student is no longer making progress toward identified goals.
- The difficulties the student demonstrates no longer interferes with academic performance in special education.
- The service is not needed for the student to benefit from his/her special education.
- The student's parents request the termination of services.
- Self-help skills
- Fine motor skills
- Visual motor skills
- Visual perceptual skills
- Eye-hand coordination
- Bilateral coordination
- In-hand manipulation
- Motor planning
- Strength
- Endurance
- Regulation
- Sensory processing
- Body awareness
- Posture and positioning
Typical Development of Self-care, Fine Motor and Sensory Processing Skills
2-3 years
- Using toilet with assistance and having daytime control
- Distinguishing between urination and bowel movements, and names them correctly
- Feeding self simple meals using a fork or spoon
- Tolerating a range of different textured foods
- Using a napkin to wipe face and hands
- Taking socks and shoes off
- Unbuttoning large buttons
- Attempting to brush teeth
- Settling themselves to sleep at night or during the day
- Having an awareness of a parent’s approval or disapproval of their actions
- Understanding common dangers of hot objects, stairs, glass
- Expressing emotions
- Explores surroundings
- Engaging in imaginative play
- Enjoying/tolerating messy play
- Begins to be able to take turns
- Strings four large beads
- Snips with scissors
- Holds crayon with thumb and fingers (not fist)
- Uses one hand consistently in most activities
- Matches circles and squares
- Imitates circular, vertical, and horizontal strokes
- Paints with some wrist action, makes dots, lines, circular strokes
- Rolls, pounds, squeezes, and pulls playdough
- Knowing where familiar items are kept
- Sits to look at books independently
- Turns single pages of a book
- Pays attention for 3 minutes
- Points to 5-6 parts of a doll when asked
3-4 years
- Feeding self without difficulty
- Independently packing items away
- Brushing teeth independently
- Dressing and undressing self (only requiring assistance with laces, buttons, and other fasteners in awkward places)
- Tolerating different clothing textures, seams, tags, etc.
- Toileting independently
- Builds tower of nine small blocks
- Copies circle
- Imitates cross
- Uses non-dominant hand to assist and stabilise the use of objects
- Manipulates clay material (rolls balls, makes snakes, cookies)
- Snips paper using scissors
- Can count 1-5
- Knows most colors
- Playing with 2 or 3 children in a group
- Taking turns
- Can differentiate between real and pretend world
- Social encounters are acted out through play activities
4-5 years
- Developing friendships
- Following rules
- Choosing weather appropriate clothes
- Dresses and undresses independently
- Develops friendships
- Playing with 4 or 5 children in a group
- Knows shapes
- Copies cross
- Copies square
- Handedness is well established
- Cuts on line continuously
- Writes name
- Copies letters
- Can count 1-10
- Writes numbers 1-5
- Able to sit and pay attention (e.g. mat time)
5-6 years
- Morning routine at school (putting bag away, swapping readers, putting drink bottle in correct spot)
- Opening lunch boxes, zip lock bags, food packaging
- Coping in busy/noisy environment
- Packing a bag for school or other outings with assistance
- Cuts out simple shapes
- Uses a 3 fingered grasp of pencil and uses fingers to generate movement
- Copies triangle
- Can copy complex shapes, such as a diamond
- Colors within lines
- Can draw basic pictures
- Able to write numbers and letters
- Begins to be able to write simple sentences
- Should be sounding out simple words like “hang”, “neat”, “jump” and “sank”
- Pastes and glues appropriately
- 20/20 vision
- Begins to recognise others perspectives
- Knows left and right
- Begins to reason and argue; uses words like why and because
- Can categorize objects: “These are toys; These are books”
- Understand concepts like yesterday, today, and tomorrow
- Can sit at a desk , follow teacher instructions, and independently do simple in-class assignments
6-7 years
- Eating a range of food and tolerating different textures
- Showering independently
- Ties shoelaces independently
- Are willing to take on more responsibility (i.e. chores)
- Packing a bag for school or other outings with little assistance/prompting
- Telling the time
- Knowing where their body is in time and space to coordinate body movements for ball skills
- Inhibiting the need to talk/ask questions
- Forms most letters and numbers correctly
- Writes consistently on the lines
- Demonstrates controlled pencil movement
- Good endurance for writing
- Can build Lego, K’nex and other blocks independently
- Develops a longer attention span
- Understands fractions and the concept of space
- Enjoys reading a book on their own
- Recognises others perspective
7-8 years
- Recalling events and describing them
- Remembering a sentence to write that was just thought about or told
- Attending for longer periods of time
- Sitting still (e.g. in class, at mealtimes)
- Taking on more responsibilities e.g. chores
- Telling the time and displaying time management skills
- Inhibiting the need to talk and ask questions
- Preparing simple meals e.g. cereal, sandwich
- Maintains legibility of handwriting for entirety of a story
Adapted from: https://childdevelopment.com.au/resources
Therapists use a lens of universal design for learning to consider the needs of all students, especially those with diverse learning. The goal of UDL is to use a variety of teaching methods to remove any barriers to learning and give all students equal opportunities to succeed. It’s about building in flexibility that can be adjusted for every student’s strengths and needs.
UDL is weaved into our everyday lives and school settings such as:
- Curb cut-outs, ramps, automatic doors, and elevators
- Accessibility features on a smart phones
- Using closed caption, digital or audio text
- Flexible work spaces and task lighting
- Lever door handles and flat panel light switches
- Presenting a visual schedule to the whole class
- Assignment options - multiple means to demonstrate knowledge including oral presentations and group projects
By applying UDL principles, therapists assist schools to effectively instruct a diverse group of learners. They do this by building in flexibility in the ways learners can access information and in the ways students can demonstrate their knowledge.
For more information on UDL, visit www.understood.org
Functional Skills
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Considerations, strategies and suggestions to try:
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Pencil grip
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Try tiny writing utensils-broken crayons, flip crayons, pencils sharpened down to about 2”. Try working on vertical surfaces like an easel or use a binder as a slant board.
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Printing
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Consider size, placement, lined paper, posture. Does the desk fit the child so their feet are flat on the floor?
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Written Production
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Consider technology such as using voice to text or keyboarding to address concerns of production rate and amount.
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Drawing
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Use a mirror when drawing a person, offer step by step visual guides.
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Scissor use
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Consider smaller scissors for smaller hands, spring-loaded scissors if trouble opening them back up; use stiffer paper/card stock for easier handling.
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Calm attention
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Have entire class do a breathing exercise or a few yoga moves; offer fidgets.
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Wakeful attention
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Consider alternative seating that allows some movement such as sitting on a yoga ball or allowing students to work at standing desks.
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Completing routines
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Try a visual schedule showing pictures for each step or activity in the list the child needs to complete.
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Shoes
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For getting shoes on correct feet, use sharpie dots.
For learning to tie: Use 2 different colored laces on each shoe.
Tying step by step guide: Shoe tying power point
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Transitioning between activities
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Post and review visual schedule of the day ahead of time and again as transition approaches; use of visual timers; routine song to accompany transition; use “First, Then”; use of preferred tasks.
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Sensory Room
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Consideration of preferred sensory tasks for regulation, safety, predictable routine and intentional breathing.
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- Pilney, Dawn
- Occupational Therapist
- 262 376-5729
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Email
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Profile
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- Scheer, Christina
- Occupational Therapist
- 262 376-5784
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Email
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Profile
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