SERVICE DELIVERY IN THE SCHOOLS

Research indicates that sustained practice of skills in natural settings facilitates the acquisition of functional skills. Therefore, direct, hands-on therapy, combined with consultation with other individuals who are involved with the student, is widely accepted by occupational and physical therapists. The process of achieving goals is shared among those working with the student, and may include therapists, teachers, parents, paraprofessionals, and others. Intervention can include adapting activities naturally occurring with the student's routine, developing opportunities for the student to practice new motor skills, positioning, monitoring of adaptive equipment, and problem solving with others to encourage motor development and independence. Therapy time is generally determined by measuring all therapist interactions pertaining to the individual student including consultation and collaboration, equipment adaptations, and direct hands-on intervention.
Key principles to consider when implementing OT and PT services include:

1. Services are provided in the student's daily routine.

The student is taught skills in real-life situations.
Therapeutic activities occur throughout the day and may be done by other people under the direction of the therapist.
Skills are generalized across different settings.
Communication between staff and families is enhanced.

2. A team approach includes sharing of information and skills to provide ongoing and accountable services.

Each student's objectives are developed and implemented jointly by the teachers, assistants, therapists, parents, and the student, when appropriate.
Regular team meetings provide opportunities for teachers and therapists to discuss student objectives, and to plan activities to be implemented throughout the day in the classroom, home and community.

3. Services are provided through a variety of methods.

The therapist:
• works directly with the student
• trains parents and school personnel in positioning and activities which may be implemented throughout the student's day
• monitors the student's status
• adapts materials and equipment
• collaborates with teachers to adapt lesson plans
• provides consultation to parents and school personnel

4. A student's need of OT and/or PT services may vary over the course of his/her educational career

There may be times when the student needs different levels of therapy intervention and these fluctuations should be reflected in the IEP or IFSP. Consideration of services may be especially necessary during periods of transition between school, community, and educational or vocational programs.

From the Handbook for Occupational and Physical Therapy Services in the Public Schools of Virginia