School Therapies

Many children need speech/language therapy, occupational therapy, or physical therapy as they grow up.  Sometimes these therapies are medical services ordered by a doctor.  Often, though, therapies are offered at school to children with disabilities. IDEA, the law that governs special education, requires all public schools (traditional and charter) to provide therapy services to children with disabilities who need therapy in order to participate in and benefit from special education.  Section 504, another federal law that protects children with disabilities, also has provisions for therapy services at school.

Parents need to be aware that the medical model, in which doctors order and control therapy services, does not apply to services offered through public schools.  School therapy services can be offered only if a child meets the detailed guidelines that are part of special education law or Section 504.  These guidelines vary somewhat from state to state, and can usually be accessed online or through the local school district.

School therapies focus on developmental deficits rather than academic skills.  Speech pathologists, occupational therapists, and physical therapists evaluate children referred by the IEP team to see if there are developmental skill deficits that both significantly affect a child’s educational progress and require specialized instruction by a therapist to remediate.   If so, that child may be eligible to receive therapy until the particular deficits are remediated.

For example, if a child has developmental deficits in visual-motor skills that significantly affect writing skills, then she might receive occupational therapy.  But once the underlying developmental deficit is remediated, handwriting is once again an educational issue.  If a child has developmental language deficits that significantly affect reading comprehension skills, he might be eligible for speech/language therapy.  But once the language skill deficits are remediated, reading comprehension becomes solely an educational issue.  Therapists are not teachers.  The purpose of therapy is the remediation of those developmental skills that support a child’s ability to access the educational environment and benefit from the educational program.

Occupational therapy (OT) includes fine motor and visual-motor skills, sensory processing, organizational and daily living skills, play and social skills, and visual-perception.  The OT evaluation identifies areas of skill deficit that significantly affect a child’s ability to meet his IEP goals.  Children are eligible to receive OT if they are eligible for special education services in one of the areas of disability and if they need OT in order to meet their IEP goals.  OT is only a related (supportive) service – it does not stand alone.

Occupational therapy can be a direct service to children, with goals in the IEP, or it can be a support plan.  Support plans allow the occupational therapist to work with teachers on how to use appropriate strategies and accommodations in the classroom.  Children are discharged from OT services when the IEP team determines that specialized therapy is no longer necessary to access their special education programs.

The eligibility requirements for school-based physical therapy (PT) services are generally the same as those for school-based occupational therapy.  PT is provided only to children with disabilities who require therapy in order to benefit from special education.   The focus is on developing and maintaining skills, within a child’s own physical capabilities, to independently and safely access the school environment and educational activities.

Speech/language therapy is available to public school students in two different ways.  First, “speech/language impairment” is one of the primary areas of disability recognized by special education law, so speech therapy can stand alone.  For example, many students, especially in the early grades, have difficulty with articulation (correctly making speech sounds) and meet the eligibility guidelines for the Speech/Language Impaired program.  These students have an IEP with speech goals, and when those goals are met the child is placed out of speech therapy and out of special education.

Speech therapy can also be a related (supportive) service, like PT or OT, for children with a primary disability in another area who need therapy services in order to access their educational program.  The speech language pathologist can work with children on fluency (stuttering), voice, speech articulation, and/or language skills.

School therapists have the same background and licensure requirements as therapists in hospitals, clinics, or private practice.  They are fully qualified to provide services to children.  Special education law requires that licensed therapists provide or directly supervise therapy services.

The goal of all school therapies is to help children with disabilities to be as independent and successful as possible as they participate in the educational process.  Therapists use specific, research-based activities, adaptation of the school environment, and consultation with teachers and parents to meet this goal.

School-based therapy is available to children with disabilities who need OT, PT, or speech/language therapy in order to access the educational environment and benefit from instruction.  Services are provided to support educational goals.  Children who require therapy for medical reasons are generally not eligible for school-based services.

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