Special Education Services

The Role of Occupational Therapy in Special Education

Occupational therapists work in all areas of healthcare, helping people live healthier lives after injury or illness. They also sometimes work with children, helping them to improve situations they are facing from disabilities or injury.

Sometimes, the work of the occupational therapist will take place inside the school. Through occupational therapy, the hope is that children with special needs can participate more fully in school by improving their fine motor skills and by having more success with daily activities.

The school may contact you to suggest that your child should be evaluated for occupational therapy. If so, this type of therapy will occur as part of the child’s Individualized Education Program (IEP). You as the parent or guardian always should have a role in developing your child’s IEP. Rely on the information on our guide to using occupational therapy in special education to consider whether this type of therapy can be helpful for your child.

Options for Using Occupational Therapy

The level of benefit a child would receive from participating in occupational therapy may vary. For some students, this type of therapy delivers amazing benefits both now and well into the future. Other students may respond much better to different techniques.

Through my past work in the special education system of a large school district outside of Seattle, I was able to see the significant benefits some students received through occupational therapy. 

I have a significant passion for this area of special education. I appreciate the ability of special education instructors to have direct impacts on students and families. Occupational therapists working inside the classroom can have a similar level of impact.

  • What Is Occupational Therapy?
  • How Occupational Therapy Works in the Special Education Classroom
  • Techniques for Deciding Whether to Use Occupational Therapy in Special Education
  • Putting Occupational Therapy to Work in the Special Education Classroom

What Is Occupational Therapy?

Occupational therapy involves using science-based techniques to help patients have more success doing things they want to do and need to do on a daily basis. The occupational therapist refers to these activities as occupations, hence the name of the therapy. These could be activities that are a normal part of the school day.

Simply put, occupational therapists are problem solvers, and they can serve as valuable members of the educational team for a qualifying student. They focus on giving students the tools to work through physical, emotional, and environmental factors.

Through the use of occupational therapy in the school, students often are better able to gain academic achievement, according to the American Occupational Therapy Association (AOTA) . It also may include improvement in non-academic activities related to school, such as sports, free play time, classroom participation, and management of behavior. These activities can also focus on things like brushing teeth, using a computer, or holding and using a pencil properly.

The occupational therapist will focus on helping the student receive more access to extracurricular activities, as well as activities that are part of the typical school day. Finding activities the student can participate in to improve both physical well-being and mental health will be important to the occupational therapist.

How Does Occupational Therapy Differ From Physical Therapy?

Although the occupational and physical therapy professions perform some similar actions and benefits for children, they are different types of rehabilitative therapy, according to the Massachusetts College of Pharmacy and Health Sciences

Although both types of therapy involve improving strength and the ability to move, physical therapy focuses more on general movements within the body, especially after an injury accident or an illness. Occupational therapy attempts to help people regain the ability to perform everyday activities.

Physical therapy fits better within a medical facility or hospital setting, as it usually occurs in the weeks and months after an accident or illness. It focuses on physical rehabilitation. 

With occupational therapy, the appointments can occur in a medical facility, usually on an outpatient basis. Think of it like an expansion of physical therapy. Because it delivers help with specific physical activities, making use of occupational therapy in school is a natural fit. 

Additionally, because occupational therapy focuses on both physical rehab and improved mental health results, it’s an ideal tool to use in the special education classroom. Therapists can focus on fine motor skills that are useful in the classroom and at home through physical rehabilitation. They also can help the student find coping strategies that help with behavioral issues and mental health issues.

How Occupational Therapy Works in the Special Education Classroom

When a school district decides to offer occupational therapy as an option, it can be helpful for parents to understand the process.

Why Schools May Need to Add Occupational Therapy

As part of the Individuals with Disabilities Education Act (IDEA), all children, including those with special needs, must receive a free appropriate public education opportunity that specifically supports with their current needs. Through the use of IDEA, school districts also should help these children prepare for their lives after their public school attendance.

IDEA protects the rights of the children with special needs and their parents or guardians to receive this type of education for free. IDEA also provides guidance and federal assistance for local school districts to meet the expectations of the act. It offers tools to help educators deliver the techniques that can help students be successful.

Many different types of educational-related therapies and techniques are available through IDEA, including occupational therapy. 

How a Student Becomes Eligible for Occupational Therapy Services

Once a school district identifies that a child would benefit from special education, the school will perform an evaluation of the child to determine the best path forward, based on the student’s individual needs. When evaluating the child’s potential need for occupational therapy, a certified occupational therapist will do the evaluation.

All of this occurs through the IEP, where a team of educators, administrators, and you (as the parent or guardian) can work together to determine which aspects of special education programs would best serve the child. The IEP team may choose:

  • Occupational therapy in conjunction with other types of special educational tools and techniques.
  • Occupational therapy alone (which would be rare).
  • Techniques that don’t include occupational therapy.

The IEP is a highly individualized plan, so one IEP team may recommend occupational therapy for one child with a similar age to your child, but it may recommend against using occupational therapy for your child. If you believe strongly that occupational therapy would help your child, you may need to present materials and data to your child’s IEP team that back up your assertion. 

Making Use of a Certified Occupational Therapist

It is important for parents to understand just what type of specialist would fit the requirements to work as an occupational therapist in a classroom. Schools cannot place just anyone in the classroom and call it occupational therapy.

Under IDEA, schools must use an instructor certified as an occupational therapist. According to AOTA, each state has its own rules and regulations for certifying someone as an occupational therapist. These regulations can include higher education requirements as well as ongoing classroom and hands-on training and testing. The regulations for the state in which your school operates would apply to your situation.

Some states only allow a certified occupational therapist to work inside the special education classroom. Other states allow a certified occupational therapist assistant (OTA) to work inside the classroom, but he or she often must receive direct supervision from an occupational therapist.

Another potential option is to have a special education teacher or aide perform the duties under the direct, close supervision of the occupational therapist.

Options for Smaller School Districts

In rural areas or for school districts that don’t have many students using occupational therapists, the district may not hire a therapist. Instead, the district may legally be able to have the child travel to a medical facility to receive occupational therapy. 

This can be frustrating for parents, but it is allowable through IDEA, as long as the district is meeting the needs of the individual student without causing the family to incur costs.

Techniques for Deciding Whether to Use Occupational Therapy

When adding occupational therapy to the IEP for your student, the team will come up with a set of techniques to use. The IEP also would contain a series of goals that occupational therapy may help the student achieve.

The team will rely on the occupational therapist’s recommendations regarding individual plans and short- and long-term goals for the student. Additionally, the therapist may need to come up with instructional ideas and techniques that teachers can use with the student for times when the therapist is not present.

Some of the general areas in which the therapist will focus when making recommendations for the IEP may include:

  • Determining the level of life skill development the student may need, such as help with grasping, manipulation of tools, drinking independently, eating independently, buttoning, lacing, and organizing items.
  • Finding ways to improve access inside non-special education classrooms for the special needs student.
  • Reducing and eliminating barriers in the school environment that prevent a student from participating as fully as he or she should.
  • Employing technology and physical tools that help the student move toward a higher level of success.
  • Studying options for helping a special needs student use alternative education techniques to improve success rates.
  • Seeking methods of helping the student improve coordination, fine motor, and gross motor skills.
  • Working on improving the student’s visual perception and sensory perception skills.
  • Determining whether specialized equipment would help the student’s educational experience.
  • Determining whether special accommodations in curriculum or extracurricular activities would benefit the student.
  • Considering whether deploying additional therapy techniques at home with the family beyond school hours would facilitate the student’s levels of success.

The IEP team will review the plan regularly. Should changes need to occur to address new concerns or successes for the student, the team can incorporate those changes in the updated plan. The assessment of the occupational therapist would play an important role in determining what, if any, changes are appropriate.

As the parent or guardian, you will have a say in how the IEP plan changes. If occupational therapy is part of the IEP for your child, remaining in regular contact with the therapist throughout the school year will help you have a better handle on whether occupational therapy is working for your child. If it is not working, the IEP team may recommend removing it completely.

Moving Toward Post-High School Success

Another important aspect of the work of the occupational therapist in the special education classroom is helping students prepare to transition to life after high school. Students receive benefits through IDEA until age 21 or until they graduate from high school. 

As part of the therapist’s work through the IEP, he or she will develop long-term goals for the student that address how the student will hopefully function as an adult. Such goals could include undertaking post-secondary education, obtaining a job, or independent living. 

Putting Occupational Therapy to Work in the Classroom

Occupational therapy appears in special education classrooms throughout the United States. In the Bismarck, N.D., public school system, for example, the occupational therapists work with students in the classroom, the cafeteria, the gymnasium, the library during computer time, and in other areas.

In Bismarck, occupational therapists attempt to deliver their work in a way that limits interruptions of the student’s normal schedule as much as possible. Occupational therapists are cognizant of trying to help a student avoid feeling as though the OT services are the focus of the student’s entire school day. 

Some examples of using occupational therapy for students with particular special needs include the following.

Autism

Occupational therapy often will focus on helping the child with autism access their education and generalize important skills. Occupational therapy does not apply a one-size-fits-all approach to children with autism.

Some kids may need help with physical skills, such as learning to care for themselves independently or improving fine motor skills. 

From a mental and emotional standpoint, the child with autism who is making use of occupational therapy may work on interacting with others in the classroom environment and on free play skills. The specific techniques and goals will simply depend on the student’s personal needs.

Eating and Swallowing Problems

Children who have struggles with feeding themselves or with swallowing food may be able to benefit from working with an occupational therapist. The therapist will study the child’s needs closely, determining the precise problem, such as dysphagia

The therapist then can deploy techniques aimed at the specific problem. These may involve preparing the food with a certain texture or performing warmup exercises related to the motions required to eat. Some occupational therapists may have special education and certification related to dysphagia.

Improving Attendance

For a student who becomes frustrated with school and dislikes going, the occupational therapist may be able to reinforce school attendance. Students who start having success with occupational therapy may begin to find school more enjoyable, leading to a higher level of attendance.

As the occupational therapist helps to remove barriers to participation for students, such as through providing assistive technologies, the student may actually look forward to attending school. When they see themselves making progress, these students can gain confidence that also helps with attendance goals.

Occupational therapists can help with both behavioral needs and learning needs, as the two items often relate to each other. Should the student with disabilities need help with anti-bullying techniques, the occupational therapist may be able to help with these as well.

Improving Focus and Participation

Students who struggle to sit still in the classroom and focus on the teacher may not have a high level of participation. Occupational therapists can introduce a number of techniques and tools that improve a student’s ability to function inside the classroom and increase participation.

If the child seems anxious in the classroom, a therapist may recommend using a weighted blanket or vest to help the child feel calmer. A sensory fidget may help as well. Removing or reducing some of these anxious feelings can give the child more confidence about participating in classroom discussions.

When the child struggles to participate because he or she cannot write quickly enough with a typical pen or pencil, the therapist may suggest trying a writing utensil with a nontraditional shape, size, or weight. 

Conclusion

Although school officials may introduce the idea of a child using occupational therapy, sometimes the parent needs to be proactive about requesting an evaluation. By educating yourself about the potential benefits of having an occupational therapist work with your student, you can better explain the advantages to your child’s IEP team.

Through my professional experience, I know how important it is for parents to bring ideas to the table for the IEP. School professionals do a good job, but none of them will know your child like you do. Your ideas are important to forming an educational plan to help your student have as much success as possible in and out of the classroom.

If you have experience with using occupational therapy with your child in the special education classroom, make contact and share your story! I also appreciate receiving questions from parents who are seeking advice about different special education techniques, including occupational therapy. Reach out by email or in the comments section below!

About the author

Emily Cummings

I am a mom of two crazy, amazing, independent, little feminists. They bring so much light to my life and a lot less sleep. Since becoming a mother and increasingly in the last year, I have witnessed parents struggling to connect with their child's special education team with no success. I have become more aware of the gaps in our public school system and how parents may benefit from empowerment and advocacy tools.

My work experiences range from a juvenile detention center to an autism specialist in the Issaquah School District and a special education teacher in a self-contained program in the Lake Washington School District. My master's in teaching focused on special education and behavioral disorders from Seattle Pacific University. I completed my BCBA coursework from Montana State University.

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