Occupational Therapy (OT): CAN OT BE A STAND ALONE SERVICE?

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Lisa:  Can occupational therapy be a stand alone related service for a student receiving special education services?

  1. Your answer about specially designed instruction lending its way to related services but can you clarify how it is that the related services of PT and SLP are able to stand alone? Is it that there is an eligibility of physically impaired and an eligibility of Speech and Language Impaired, and there is no eligibility of “occupationally impaired?”

  2. So can a student receive OT services only on an IEP (no other services) or does the child also need to have SLP to have OT? I’m seeing mixed answers.

    • Jamie, & Samantha This another area where states have flexibility with IDEA rules. 300.8(a)(2)(ii) says that a state can decide that a related service will be “considered special education”. TX has done that with speech therapy, but not other related services. Is anyone aware of states that include have other related services as special education?

      • Michigan has a speech eligibility where an SLP can stand alone. They also have a physical eligibility where a PT can stand alone. What I hear you say is Federal law indicates the student must be receiving specially designed instruction in order to be eligible for related services but each state can decide if a related service will be considered special education. Do you know where one would find what the state has ruled on this interpretation? I have never seen in writing, that would be great! Thank you!

      • So if the student has an IEP already, OT can be the only related service provider? Or do they also have to have SLP?

        I’m currently in CA and SLP can be stand alone as in the student can have a Speech and Language Impairment on their IEP only. But if they have another diagnosis, for example Multiple disabilities or Other Health Impairment is OT allowed to serve them alone or would they need the an SLP also?

        From my understanding from OT school is that, OT cannot be the only related service on an IEP, and has to be accompanied by SLP or PT. But I wasn’t sure if that had changed.

        • I have been researching this question myself. NOWHERE in federal law, in CA state law, in CA school policjes written by the Board of education, ( say for LAUSD, IS there a stated Requirement that occupational therapy can only be a standalone service and cannot be provided in theech or PT is not also provided. NOWHERE NOWHERE NOWHERE is this a written policy. Do you know where this is a written policy? In the world of health insurance for adults and maybe for kids, OT cannot be provided as a standalone service for home health services and maybe other places. So…. my question is this…..? Is school systems by themselves deciding that because they want to bill medi-cal that they will not allow OT to be the only provider, so that they dont need to pull from their federal funding.
          This is against FAPE. This is illegal. I have made this my personal goal to change this misunderstanding

  3. Hi Chuck-Regarding section 300.8 (a) (2) could you explain this in terms that a family would understand? In addition, OT is switched from direct to consult if Speech or PT is discontinued. Can you explain that too so families or other members of the IEP team understand the reasoning for this?

    • Cindy, The citation says a child must be receiving specially designed instruction in order to receive a related service under IDEA. If they are, they can receive as many related services as they need. The amount of service, & whether it is direct or indirect (consult) is recommended by the therapist. Unfortunately, this sometimes is based on factors other than the child’s needs. The team, legally, makes the final decision. The parent has the right to disagree with & challenge the recommendation or decision. They can ask for an independent OT evaluation & use the dispute resolution processes.

    • OT moving from direct to consult should be a separate discussion, that should be a team decision. Speech is instructional in most states and therefore, OT can continue if the educational goals require OT for that child to benefit from spec ed. For example, the child might have the SLP address his SLD in written expression with an assistive technology device. In my state (TX), I could (as the OT) stay on the IEP comfortably. In that case, OT and ST would be on the IEP.

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