What is school-based OT?

The goal of school-based occupational therapy (OT) is to help students access their educational curriculum in the least restrictive way possible.

(Clark et al., 2017)

Key Concepts

Service Delivery Models

Direct

Directly working with student
Individual or group
Pull-out or push-in

Pull-Out

Services provided in a space other than the child's main classroom
Pros: More controlled intervention environment, can direct more attention to specific areas of need
Cons: Reduced time spent receiving general education instruction, potential challenges with transfer of skills

Indirect

Consultation with members of IEP team (e.g., teachers, instructional aides)
Education about child's needs
Recommendations for classroom environment

Push-In

Takes place within classroom
Pros: Development of skills within their true context, increased collaboration with classroom staff
Cons: Increased distractions, limited privacy

School-based OT is a designated instructional service (DIS) under IDEA (not a stand-alone service).
The medical model of OT involves more direct intervention to promote functional independence.
School-based OT emphasizes collaboration with teachers/other IEP team members, providing a blend of direct and indirect services, and pushing into the classroom as much as appropriate in order to promote the transfer of skills across the educational environment in the least restrictive way possible.

Recommending Individualized OT Services

1. Student must eligible to receive services under an Individualized Education Plan (IEP)

2. Assessment Plans typically from Program Specialists or Case Managers*

3. Evaluation must be completed by an Occupational Therapist

*When recommending for a child to be assessed, consider: Can the barrier be addressed with slight modifications or do they need continued practice and skilled training?

(Clark et al., 2019; Case-Smith, 1996; Watt et al., 2021)

Support A Variety of Skills

School-based occupational therapists typically target the following performance skills as they relate to school functioning. While OTs can provide skilled intervention for students who are eligible, teachers can also implement strategies to support these areas. These strategies can be implemented on a classroom-wide scale (Tier I) or directed towards at-risk students (Tier II). It is recommended to trial various strategies for 4-6 weeks before consulting further with an OT to propose individualized services (Tier III).

Fine Motor Skills

The ability to use the fingers, hands, and arms for functional tasks

Sensory Processing Skills

Receiving, interpreting, and organizing information from the environment in order to produce an appropriate response

Visual Motor Skills

The ability to take in visual information from the environment and translate it into a motor action (hand-eye coordination)

Emotional Regulation Skills

The ability to understand one’s emotions and manage behavioral responses to emotional situations

Learn More

Foster an Inclusive Learning Environment

Universal Design for Learning (UDL) is a framework that aims to foster an inclusive learning environment and make learning accessible to all students by catering to different learning styles. Learn more about UDL Guidelines and ways to implement UDL in the classroom at the link below.