Prepare the child for the path, not the path
for the child ~ AnonWhat is Occupational Therapy?
In order to facilitate a
better understanding of Occupational Therapy services, we would like to
provide you with the following definitions:
1.
California Department of Education
Guidelines for
Occupational Therapy and Physical Therapy in California Public Schools (Pg. 9):
Occupational therapy
includes services to address the functional needs of a child related to
adaptive development, adaptive behavior and play, and sensory, motor, and
postural development. These services are designed to improve the child’s
functional ability to perform tasks in home, school, and community settings
and include:
(i)
identification, assessment, and intervention;
(ii)
adaptation of the environment & selection, design, & fabrication of
assistive & orthotic devices to facilitate development and promote the
acquisition of functional skills; and
(iii)
prevention or minimization of the impact of initial or future
impairment, delay in development, or loss of functional ability.
2.
California Department of Education
March 30, 1999 Revision,
Title 5, California Code of Regulations, Division 1, Chapter 3, Subchapter 1,
Special Education, Page 25, (n) (1):
“Occupational therapy”
means the use of various treatment modalities including self-help skills,
language and educational techniques as well as sensory motor integration,
physical restoration methods, and prevocational exploration to facilitate
physical and psychosocial growth and development.
3.
The American Occupational Therapy
Association, Inc.
Occupational therapy addresses function and uses specific
procedures and activities to a) develop, maintain, improve, and/or restore the
performance of necessary functions; b) compensate for dysfunction; c) minimize
or prevent debilitation; and/or d) promote health and wellness.
Categories of function
are defined as: Occupational Performance Areas and Performance Components.
Occupational performance areas include
activities of daily living, work activities, and play/leisure activities.
Performance components refer to the functional abilities required for
occupational performance, including sensory motor, cognitive, and
psychological components. Deficits or delays in these Occupational
performance areas may be addressed by occupational therapy intervention.
PEDIATRIC BUILDING BLOCKS
Occupational Therapy (OT) helps individuals
who have a physical or mental deficits resulting from injury, neurological impairment,
disease, and/or other conditions. Occupational Therapists design activities that stimulate
development or recovery in areas of work, play, and self-care. Therapists also instruct
family and staff who assist them. Pediatric therapists are specialists in child
development, including developmental delay, learning disabilities, and/or
physical, mental, and emotional impairment.
Pediatric Occupational Therapy concentrates on the growth and
development of children ages 0 to 21 years. The occupation of a child is to grow, learn,
and develop through play, socialization and academic instruction.
As with "building blocks" you can not build a complex
structure with out a solid foundation. A child must first learn to roll before crawling,
crawl before standing, stand before walking. The seemingly simple tasks that humans
perform are actually an extremely complicated series of actions and reactions.
As an example, in order to write in a legible and comfortable way one must first
have control and stability of trunk and shoulder muscles. Should one doubt this, try
this little demonstration: sit in a hard chair, that does not allow your feet to touch the
floor, now slump over, relaxing your tummy and back, now try to write. With
that in mind, note that improving a child's handwriting may be as easy as insuring that
the chair and desk is the correct size!
Educational Occupational Therapy differs from medically
necessary OT. Both Federal and State law dictate that educational service concentrates on a child’s ability to
function in and receive benefit from their education in the school setting, "to attain a free and appropriate education."
Pediatric Building Blocks is located in
California, therefore, the following information is based on California educational law and
therapy practice.
In the academic setting,
Occupational Therapy (OT) is provided as a "Designated Instruction Service
(DIS)", sometimes also known as a 'Related Service'. A service defined by the
federal Individual with Disabilities Education Act (IDEA), state laws, and
education codes, to provide needed support to a special education student so that they may
benefit from their education program. OT Services provided through the school district are
provided according to the "Guidelines for Occupational Therapy in California Public
Schools" published by the California Department of Education (quotes from this
publication are noted in italics.) According to these guidelines "OT services are
provided when the IEP designates such services as necessary for the child to meet
educational goals and objectives."
Occupational
Therapy - Designated Instructional
Service (DIS),
delivered by public education agencies are provided according to California
Educational Code 56363(a). Assessment and therapies are designed in consideration of the
child’s’ diagnosis as related to academic issues and function. The purpose is to
identify areas of deficit then design and implement reasonable accommodations as
appropriate for the school environment.
Using this Ed. Code as a guide, the
therapist should ask the
following questions:
A. Does
this student require occupational therapy (OT) service in order to receive
benefit from their educational instruction?
B. Can
this student’s needs, reasonably be met within their academic program?
Are current IEP team
members qualified to provide the needed activities, and is it
reasonable and feasible for them to do so?
C. Does
this student require the services of a skilled OT to achieve their academic
goals and objectives?
Educationally necessary therapy means "directly
related to performance in the educational environment." It must be
described within the student's IEP (as DIS), listing frequency and expected duration of
therapy services. Goals are to be collaborative and measurable based on levels of
functional skills. This means everyone working with your child may work on the same goals
using different techniques and methods. Specific "OT goals" may not be
necessary. "Educationally necessary therapy is delivered in the school
environment using the least restrictive environment (LRE) in collaboration with the
educational staff" during the regular school day for the student's peer group (Title
5, California Code of Regulations for Special Education) unless otherwise specified by
the IEP team.
Medically necessary therapy is provided by a
private medical service provider or agency, such as California Children’s
Services (CCS) (Government Code, Chapter 26.5, section7575.) "A child may have
both a medical and educational need, however some motor difficulties may not directly
impact educational progress and may not constitute an educational need."
Families who are currently
receiving therapy services from CCS for their student, need to check with the special
services unit in their school district as many districts do not provide "duplication
of services." This means when a student is receiving therapy from CCS, they are
not eligible to receive additional services from the school district.
Families should keep this in
mind when obtaining referrals for school based therapy from medical care providers.
When families have a medical referral they are presenting to their
school, it is important to ask the medical provider for specific expected educational
outcomes. Just as doctors are asked to justify
referrals by insurance companies in private practice, when referring to
school based therapies, they should be able to specify diagnosis, reason for the therapy
referral, the expected length of service and expected outcomes.
