Providing Services in Inclusive Settings
Under SPED law (IDEA), OT services, whenever possible, are provided within the (LRE) natural routines and activities of the educational program
Participation in the classroom is the goal and so this natural environment should be considered the PRIMARY environment
The first question to ask when determining intervention services is: Can this student’s participation needs be effectively addressed through intervention in context
Start with least restrictive – start with accommodations – consultation
Consider pullout services only if the participation goals cannot be effectively addressed and met through intervention in the classroom or within natural contexts
If pullout services are recommended, their duration should be carefully considered and these services provided only until intervention in context can be satisfactorily achieved
Removal from the general education classroom is a very restrictive option and must be carefully considered in the context of the child’s prioritized needs
Less restrictive options are often available and legally, they must be used if they meet the student’s participation needs.
Emphasis is on problem solving and ongoing collaborative consultation
Allows teacher and OT to work collaboratively so that strategies and accommodations can be applied regularly and with confidence by the teacher and classroom staff
Incorporates intervention strategies into daily routines and environments significantly increasing the opportunity for practice, thus increasing the likelihood of reaching participation goals
Increases opportunity to observe and problem solve how the student can best function in their particular environment (this is not typically best accomplished through pull out services)
The client may include the student, parents, teachers, and other team members
An occupational therapist can have a profound impact on a student through accommodations and consultation. The presence of a disability does not, in and of itself, mean that the student should receive individual pullout OT services. For example, for a student with sensory defensiveness, more than half of the battle can be met by reframing the student’s behavior to the parents, teachers, student and other team members (all are your clients) so that they understand where the behavior is coming from. The OT can then educate the parents, teachers, student and other team members about strategies to effectively deal with the problem so that they are empowered to problem solve solutions in the moment. If the OT effectively educates their ‘clients’, then they are not the only one figuring out solutions. This is important because the OT is present in the context of the student’s day-to-day functioning much less than the parents and teachers. While OT cannot always be there, they can have a tremendous impact on the lives and successful participation of students through education, consultation and accommodations.