Parents Ask About Occupational Therapy Services in Schools

My child was recently referred for an OT evaluation. Exactly what is OT and what will it do for my child?

School-based occupational therapy is designed to enhance the student's ability to fully access and be successful in the learning environment.

This might include working on handwriting or fine motor skills so the child can complete written assignments, helping the child organize himself or herself in the environment (including work space in and around the desk), working with the teacher to modify the classroom and/or adapt learning materials to facilitate successful participation.

How do I get OT for my child?

Occupational therapy (OT) is a related service under Part B of the Individuals With Disabilities Education Act (IDEA), and is provided to help a student with a disability to benefit from special education. As such, OT is a supportive service. If your child has a disability, as defined by IDEA, and needs special education and related services to meet unique learning needs, then he/she might be eligible for OT services. Your child must be eligible for special education before being considered for OT services in the schools under IDEA. Eligibility for special education does not mean automatic eligibility for related services, including OT. The final determination is made by the multidisciplinary team in concert with the OT evaluation.

My child needs OT. The district wants to use an Adapted Physical Education (APE) Teacher, Certified Occupational Therapy Assistant, or Classroom Aide to provide the therapy. Is this legal?

According to the IDEA, occupational therapy is to be provided by qualified and trained practitioners. Occupational therapy practice is regulated in 51 jurisdictions, including the District of Columbia and Puerto Rico, and each jurisdiction defines who can legally provide OT services. In many cases, OT can only be provided by an OT practitioner (as defined by state law). Certified occupational therapy assistants (COTAs) are qualified occupational therapy practitioners who work under the supervision of occupational therapists.

In certain circumstances, an aide can perform specific tasks as delegated by and under the direction of and with intense, close supervision by an OT practitioner.

My child was recently evaluated by an OT, and I have some concerns about the test used. Are there particular tests that should be used?

Occupational therapists are responsible for determining the need for OT services. This is done via the data collection (evaluation) process, of which administering a particular test is only one part.

The therapist may use screening, standardized or non-standardized tests, depending on the need and type of information sought, which in this case should be directly related to your child's ability to function and be successful in school.

While there is not one particular assessment tool that "should be used," the therapist should be familiar with a variety of methods to gather the necessary information and to make an informed decision.

We live in a rural area and have to travel great distances to have our child receive OT in the nearest hospital because the district does not have therapists. How can we get more OTs in rural areas?

Your situation is not unusual. Many rural communities have had difficulty recruiting and retaining OT practitioners. Because of this districts often have to contract with therapists or other agencies which are located some distance away.

Rural and other communities might consider highlighting the attractiveness of their areas when trying to recruit OTs and other needed staff. Contact the OT association in your state to find out what you can do to help make sure OTs know about job opportunities available in your area.

I have asked the district to provide sensory integration therapy for my child. The school OT seems unwilling to do this. What can I do?

Sensory integration is one frame of reference or perspective which might be used in the occupational therapy intervention process. The service or therapy that school districts are mandated to deliver is occupational therapy.

In the schools, the focus of OT is on the child's ability to function in the educational environment.

As long as the child's educational needs are being appropriately met, the school-based OT is operating within his/her scope of practice and training.

Each occupational therapist, using professional judgment, evaluation data, and expected outcomes, selects a particular frame of reference which will guide the intervention. You are encouraged to discuss your concerns with the school therapist to help you understand the reasoning used to guide the intervention.

Where can I find more information about occupational therapy for my child?

  • the principal of your child's school
  • the special education director or coordinator for your child's school district
  • the occupational therapy association in your state

American Occupational Therapy Association, Inc., and the American Occupational Therapy Foundation 4720 Montgomery Lane P.O. Box 31220 Bethesda, MD 20824-1220 ConsumerLine 301-652-2682