Linn Benton Lincoln Education Service District (LBL ESD) Cascade Regional Orthopedic Impairment Services and/or Non-Regional Mild-Moderate Occupational-Physical Therapy Services provide school-based Occupational Therapists (OT) and/or school-based Physical Therapists (PT) to support educational and developmental access for students and children demonstrating significant fine/gross motor, sensory motor, and/or safety skill deficits as compared to same age peers. Cascade Regional provides family focused, early intervention home-based services for children who are birth-3 years. School age services are provided to students in their educational setting which includes both preschool-based services for children three to five years old and primary/secondary services for students Kindergarten through 21 years old. These educationally related services may consist of modeling, coaching and consultation with school staff and families based on individual child needs.
Occupational Therapy (OT)
Occupational Therapy is a profession focused on helping individuals of all ages learn (or re-learn) to participate in activities that “occupy” their time during the day taking into consideration physical, cognitive, or social limitations. Educational OTs help school staff create plans for students to develop and maintain educationally necessary skills such as:
- Fine motor skills
- Visual motor skills
- Self-help/self-advocacy
- Safety Awareness
- Personal care/feeding skills
- Psychosocial skills
- Play and recreation
- Community Integration/Work
- Learning Skills
- Adaptive technology
- Modification of equipment and environment
Physical Therapy (PT)
Physical Therapists play an important role in both developing standards for school staff to assist students with gross motor deficits and in developing health care protocol to ensure safety, availability, accessibility, and self-care in the school environment. Areas addressed by the PT include, but are not limited to:
- Gross motor skills
- Positioning
- Wheelchair and equipment needs
- Postural control
- Gait training/mobility skills
- Consulting on braces, splints, prosthetics
- Transfer and safe handling techniques
- Environmental adaptations and accessibility
Who is Eligible for Regional OT/PT Services?
Orthopedic Impairment (OI) is considered a Regional (“low incidence, high need “) disability. Children and students who have a medical or a health assessment statement indicating a diagnosis of an orthopedic or neuromotor impairment may qualify under the OI eligibility. Oregon Administrative Rules 581-015-2160 https://oregon.public.law/rules/oar_581-015-2160
Who is Eligible for Mild/Moderate (non-Regional) OT/PT Services?
Children and students who are eligible for special education under any eligibility category and demonstrate significant skill deficits compared to same age peers in the educational setting such as the classroom, cafeteria, playground, gym, bathroom, etc. with regard to (not an exhaustive list):
- Feeding
- Toileting
- Clothing management
- Orientation and travel on campus
- Organization and materials management
- Transfers and positioning
- Task-related mobility
- Safety awareness
- Following demonstrations
- Play, fieldtrips
- Graphic communication
- Gross motor tasks
Educational Supports vs. Medical Supports
Physical and occupational therapists work in both school environments and medical environments. As related service providers in schools, therapists are limited in the range of services they can provide due to the requirements in the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act (Section 504).
| OT/PT in Educational Settings | OT/PT in Medical or Out-Patient Settings |
|---|---|
| Educational goals are primary. | Patient goals are primary. |
| To reduce effects of chronic conditions so the student can benefit from the educational program. | To treat acute conditions or for short-term intense interventions in chronic conditions. |
| Larger caseloads, more consultation and collaboration, minimal direct services. | Smaller caseloads and patients generally come to the clinic to see the therapist for direct therapy. |
| Services are integrated with majority of time given to communicating with school service providers. | Services tend to be discipline based with 1:1 therapy time. |
| Focus is on functional skills and adaptations that promote the attainment of educational objectives. | Focus is on developmental milestones and components of movement within functional skills. |
| More responsibilities are shared collaboratively with the educational team. | Parents are instructed in physical management. Few responsibilities are delegated except to parents. |
| State and federal laws for special education documentation is based on specific eligibility. | Documentation is based on clinical progress for insurance/third party reimbursement. |
What Services may be Provided?
Evaluation – Children referred for evaluation are assessed for developmental and functional fine motor and gross motor skills, positioning, equipment needs, activities of daily living, and mobility.
Consultation – Providers direct consultation to school staff and early intervention families for children eligible for services. Classroom teachers and interventionists are assisted with program development and interpretation of medical information. In-service training opportunities are available to enhance knowledge and understanding of issues impacting children’s progress toward Individual Family Service Plan (IFSP) or Individual Education Program (IEP) goals.
Integrated Service Delivery – Providers assist in the implementation of IFSP and IEP goals with a focus on adaptations and functional skills that promote progress toward those goals. Educational OT and/or PT providers support to school staff toward the collaborative implementation of student and children’s educational goals. A library of equipment is available for loan including assistive technology, positioning equipment, recreational equipment, and mobility aids.