School Based Occupational Therapy for Special Needs Children: Evaluation & Strategies

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School Based Occupational Therapy

Occupational therapy (OT) is a health-related service that is beneficial for many children who have been identified as having special needs. Occupational therapy is a related service under Part B of the Individuals with Disabilities Education Act (IDEA). Students who receive special education services through the public schools are entitled to free occupational therapy sessions, provided that they qualify after an OT evaluation.

However, a student must be eligible for special education before being considered for OT services in the school system. A student should only be referred for an OT evaluation if their difficulties are impacting their ability to meet the goals and objectives set forth in their individualized education program (IEP).

An occupational therapy evaluation can be requested if the services are necessary to enable a student to meet the measurable annual goals set out in the IEP, and to participate, as appropriate, in the general education curriculum. School based occupational therapy is provided in order to help children who struggle with a variety of daily activities, including those that involve fine motor skills, self-help skills, visual-perceptual issues, sensory responses, organizational skills, and behavioral challenges.

Special needs children in the public school system often receive occupational therapy services one or more times a week as determined by the recommendations of the therapist along with those of the Individualized Educational Program team.

Occupational therapists who provide school based services will often work with a child one on one or in a small group setting outside of the mainstream classroom, and some special needs children have these services integrated into the larger classroom environment. Students who are participating in school-based occupational therapy will receive assistance from trained professionals when learning to master such skills as holding a pencil properly, writing letters and numbers, staying focused on a classroom lesson, learning to adapt to sensory stimuli, or buttoning/zipping clothes.

Occupational therapists will typically devise a plan of short-term objectives and longer-range goals for a student to meet, and will stay in contact with teachers, administrators, and parents in regard to a child’s progress. More examples of problems that cause students to be referred for therapy include:

  • Poor printing legibility

  • Poor organization of work on page

  • Poor grasp on writing utensil

  • Poor letter proportion/formation/placement

  • Quality of written work is poor

  • Time to complete written work is inadequate

  • Copying from book/board is difficult for the student

  • Pencil pressure is too hard or too light

  • Student does not stabilize paper

  • Poor posture when writing

What is an Occupational Therapy Evaluation?

What happens when the OT evaluations a student? Typically, the school occupational therapist will test the student and:

  • Measure the level of physical strength and endurance.

  • Analyze fine motor control, such as the ability to hold a writing utensil.

  • Determine visual and perceptual ability that influences a child’s ability to form letters and shapes using a writing utensil.

  • Suggest home activities that promote the development of skills needed in good handwriting.

  • Make recommendations for a level of services.

Occupational Therapy Strategies

Here are a variety of strategies that a school occupational therapist might utilize to address issues that commonly impact performance in the school setting:

  • Provide the child with alternative writing paper (i.e. using raised lined paper for tactile feedback on proper lettering heights).

  • Give the student alternative writing utensil/grips.

  • Provide a visual model on desk/board.

  • Slanted or vertical writing surface (easel or chalkboard).

  • One on one instruction/practice.

  • Decrease visual clutter.

  • Offer practice sheets.

  • Practice forming letters in various tactile media, such as using shaving cream for forming letters and working math problems (Think multisensory!)

  • Practice forming letters using wikki stix.

  • Handwriting programs to music.

  • Tracing through mazes.

  • Theraputty manipulation and games.

  • Help develop and evaluate handwriting curriculums and collaborate with teachers on effective strategies.

Importance of Occupational Therapy

Special needs children who begin receiving regular occupational therapy services from an early age onward will have the best chance of developing skills that are needed for a productive adulthood. Some children will be able to qualify for occupational therapy before they reach school-age through an early intervention program.

The aim of the therapist is to help a child with special needs to function as independently as possible, and this process can include tasks such as strengthening short and long-term memory skills, improving coordination, and assisting in the acquisition of grooming and cooking skills.

School based occupational therapy is widely offered to children with a variety of special needs, including autism spectrum disorders, cerebral palsy, visual or hearing impairments, and muscular dystrophy. Occupational therapists must be licensed and certified in each state, and should be able to display a great deal of patience as well as strong social skills.

School based occupational therapy for special education students is highly recommended by experts as a way for children with disabilities to gradually acquire the skills that develop more easily in their mainstreamed peers. Parents or teachers who feel that their child or student may qualify for occupational therapy services can suggest an evaluation from their school district of residence.