Occupational Therapy

As a related service the goal of occupational therapy (OT) is to enable students with disabilities to be functional participants in their educational environment.  Occupational therapists (OT’s) provide services when indicated to assist a child with an educational disability benefit from his/her educational program in the least restrictive environment.   Services may be directly to students; or on behalf of students to school teams, and families.

School OT intervention addresses performance skills where a child’s disability impacts or compromises the ability to make progress in the natural learning environment.  There may be aspects of a student’s disability that do not interfere with education but could be addressed by an occupational therapist in another setting. 

How are OT services delivered?
Services are provided to and on the behalf of students. Strategies and interventions are embedded where possible into naturally occurring activities and routines within the educational program.

OT services on behalf of student may include:
  • Explaining how a student’s medical ,fine/visual motor or sensorimotor problems will affect school performance
  • Suggesting modifications to school activities and the school environment
  • Adapting materials for use in school
  • Referring a student for an assistive technology consultation
  • Helping to set realistic expectations for the student’s performance
  • Monitoring the effectiveness of therapeutic modifications and accommodations carried out by school personnel
OT services provided directly to students either individually or in a group may include:
  • Exploring and monitoring seating and positioning adaptations to increase independence and participation in school activities. Example:  extra support to allow control for writing or cutting tasks
    Exploring modifications to school activities. Example:  adapting worksheets and using materials that are easier to handle or to control
  • Exploring individualized adaptations of school materials to increase independence and school participation.  Example:  adapting mealtime utensils, pencils, or scissors
  • Developing a program of therapeutic activities to support a student’s performance in the educational environment.  Example:  hand strengthening activities for writing, cutting, or opening containers
  • Training school staff in techniques for handling, mealtime participation, or helping a student use special equipment and then monitoring use of the techniques
  • Ongoing reassessment of the student’s needs and the role of OT in addressing those needs
How is the need for OT services determined?
In order to receive school-based OT services, students must be identified as having a disability that meets the criteria under the IDEA.  The school team, which includes the parents/caregiver, establishes the child’s present levels of academic achievement and functional performance and develops an Individualized Education Program (IEP). The need for OT and/or PT services is not based on specific test scores or discrepancies, rather on whether the unique expertise of the therapist is required for the student’s educational participation. Some students, while not eligible for special education services, may qualify under Section 504 of the Rehabilitation Act of 1973.  The 504 Plan specifies the accommodations that are necessary for a student to access educational activities and may involve input from an OT or PT.
Who provides school OT services?
School OT services are provided by Maryland licensed occupational therapists and Maryland licensed occupational therapy assistants.  OT’s and OTA’s are part of the multidisciplinary team that plans and monitors the student’s special education Individualized Education Program or 504 Plan.
When are OT services discontinued?
Discontinuing services is warranted when the IEP or Section 504 team determines that the child no longer requires the unique expertise of the occupational therapist to achieve educational benefit.  Factors in this decision include:
  • Child has met the functional goals
  • Deficits are no longer interfering with the child’s ability to function within his/her educational program
  • Strategies can be implemented by the current educational team
  • Equipment and environmental modifications are in place and are effective
  • Level of participation is within expectations for the child’s educational program
  • Rate of skill acquisition, potential for progress and/or level of function are not likely to change with therapy intervention
What is the difference between school OT and community medical OT?
A medical diagnosis or motor delay confirmed by evaluation results does not automatically indicate a need for school based OT. There must also be an adverse impact on the student’s performance or access to his/her education. School-based OT is not intended to replace community medical services, but is provided only when identified problem areas directly affect educational performance that indicates a child needs related service to benefit from special education. Many children can benefit from collaboration between school-based and community based service providers.
How can I find out more about school-based OT services?
If your child attends a Baltimore county Public School:
Contact your child’s teacher or school administrator.
If your child is birth to three years:
Contact Baltimore County’s Infants & Toddlers Program at 443-809-2169
If your child is three years old to 21 years old and does not attend a BCPS school:             
Contact the Office of Child Find at 443-809-3017