The scope of Occupational therapy is defined by the American Occupational Therapy Association (AOTA) in its simplest terms: occupational therapists and occupational therapy assistants help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes.
Occupational therapy practitioners in educational settings work with children, youth, and their families, caregivers, and teachers to promote active participation in activities or occupations that are meaningful to them. Occupation refers to activities that support the health, well-being, and development of an individual (American Occupational Therapy Association, 2014).
Occupational therapy practitioners collaborate with parents/caregivers and other professionals to identify and meet the needs of children challenged by delays in development or by reduced development. Once the needs are identified, occupational therapy involves modifying or compensating for any barriers that interfere with, limit, or prevent functional performance; instructing and modeling skills to children, their families, and other adults in their environments to expand therapeutic strategies to all aspects of daily life tasks; and adapting activities, materials, and environmental conditions so children can participate under different conditions and in various settings (e.g., home, school, sports, community programs).
SCHOOL-BASED OCCUPATIONAL THERAPISTS
School-based occupational therapy is available for students who are eligible for special education. School-based occupational therapists and occupational therapy assistants contribute to a student’s skills and abilities to enable participation in school activities or “occupations.” The services of a school-based OT are mandated by federal and state laws under IDEA. Related services are defined as a necessary service to enable a student to participate and to receive a free, appropriate public education in the least restrictive environment. School issues need not address medically based needs.
Academic support by an occupational therapist may include written expression, organization, peer relationships, sensory supports, self-help skills, handwriting, motor planning, postural control, smooth & rhythmical movements, endurance and adaptations to the environment. The locations for these services in school settings may include playgrounds, classrooms, lunchrooms, and bathrooms. Typically, the OT interacts with school personnel throughout the school year, exchanging ideas and information.
CLINIC-BASED OCCUPATIONAL THERAPISTS
Clinic-based occupational therapy provides intervention and plan of care that is medically based. Clinically based occupational therapy may address these functional deficits across the settings of home, school and community. Medically based therapy is carried out in outpatient and hospital settings or private clinics. Services must be initiated and documented by a physician referral and must be supported by a medical diagnosis.
While these descriptions in general hold fast across the United States, it is important to be aware of your own state guidelines as there can be differences in interpretation on a state-to-state basis.
Physical therapy (PT) is one of the related services mandated by the Disabilities Education Act (IDEA) under part B, available to those on an Individualized Education Program (IEP). Students may benefit from physical therapy services if their lack of a motor skill set restricts their educational performance, their involvement and their capacity to access and therefore benefit from the academic curriculum.
SCHOOL-BASED PHYSICAL THERAPISTS
The school-based PT designs a plan of care and performs therapeutic interventions that focus on functional mobility and safe access including participation within educational activities. These services are typically provided in classrooms, special classes, playgrounds, and lunchrooms. Typically, physical therapists and physical therapist assistants (PTAs) address posture and positioning; range of motion, equilibrium and protective reactions; manipulative skills; mobility; muscular and cardiopulmonary systems; strength and endurance, and use and adjustment of adaptive equipment. Primarily, PT’s support and ensure safe movement throughout school environments.
CLINIC-BASED PHYSICAL THERAPISTS
The clinic-based PT addresses a medical diagnosis in a hospital, outpatient setting, and private clinic or at home. Referral is initiated by a physician based on a specific medical diagnosis or delay in one or more areas of development. Services are often used after a medical procedure, surgery, Botox or injury to maximize recovery and function in a brief period of time. Often times in clinical settings, the patient is offered a wide range of modalities and rehabilitative equipment.
Occupational and physical therapy services under Section 504 of the Rehabilitation Act of 1973 prohibit discrimination based on disability for any program receiving federal funds. Students with disabilities who do not qualify for special education and related services under IDEA may qualify for accommodations under Section 504.