The Occupational Therapy Evaluation
An initial evaluation must be completed in order to determine eligibility for special education. When a student is referred for a special education evaluation, the team works through a formal evaluation process to determine whether or not the referred student is eligible for special education services.
The role of the occupational therapist in the public schools is to enable student participation. The purpose of the school-based occupational therapy evaluation is to assist the team in determining eligibility for special education services and, once eligibility is determined, to provide information to assist the team in formulating an appropriate educational plan.
The evaluation team, including the occupational therapist draws from a variety of assessment tools and strategies in order to gather functional, developmental and academic information that may assist in determining the presence of a disability and the educational needs of the student.
Special education law applies only to problems identified that interfere with the student’s ability to participate in his or her school program. The OT evaluation must address educational reason(s) for referral. The OT evaluation typically utilizes a combination of observation, standardized testing, and non-standardized testing, to assess all areas of concern related to the student's performance in school. The results of the OT evaluation are used in conjunction with information from other team members to assist the team in determining eligibility and, if eligible, in developing the IEP.
Critical sources of information in the occupational therapy evaluation process include:
Information provided by and the perspective of the student, teacher and parent
Observation of the student within the educational setting (context) where they are experiencing difficulties
Evaluation data –information from assessment tools
Is there a school participation problem?
Using the OT Practice Framework, a top down approach, the occupational therapist first considers the school participation problem and then looks at the underlying reasons for this participation problem.
I. Development of the Occupational Profile
Clearly identify the reason for referral. What is the difficulty that the student is experiencing in his or her educational program that has resulted in a referral for an occupational therapy evaluation? If a request for an occupational therapy evaluation is received with insufficient information as to the reason for referral, it is important and well worth the time in the beginning of the process to dig deeper to clearly identify the reason for referral. This may involve interview/discussion with the parents, teachers and other team members. If the reason for referral is not clearly identified, the OT runs the risk of not answering the appropriate questions in their evaluation. This, in turn, can result in parent dissatisfaction with the OT evaluation and requests for costly independent evaluations. The OT evaluation addresses all areas of suspected disability related to the reason for referral.
Gather information necessary to determine the appropriate assessment tools and strategies. This information, along with the reason for referral, constitutes the student’s Occupational Profile.
- Review and consider instructional support/pre-referral/early intervening information
- Conduct a record review
- Interview parent, teacher, and other members of the school team as deemed appropriate
II. Analysis of Occupational Performance
Observation of the student is a critical step in the evaluation process. The observation of the student centers on the reason for referral. The observation therefore, should take place in the setting in which the student is experiencing the difficulty that resulted in the referral. Observation of the student involved an analysis of the interaction of the student’s abilities, the activity demands, and the context in which they routinely occur as they contribute to the student’s participation.
Standardized and non-standardized assessment tools and strategies are selected based on all of the above information. Use of available evidence also informs the selection of assessment tools. The tools and strategies selected are individualized to the student and reason for referral. The occupational therapist needs to individualize their evaluation process for each student rather than completing the same generic evaluation process for all.
Assessment results are interpreted. The analysis of the assessment results and occupational profile information contribute to the understanding of the student’s strengths and weaknesses as they relate to the reason for referral. This information is presented concisely in the written occupational therapy report.
Areas identified as interfering with school participation are address through the special education process. Areas noted that do not interfere with school participation are acknowledged but not addressed through the special education process. Parents have the option of addressing these issues on their own outside of the school setting.
Under IDEA 2004, a reevaluation is completed at least once every three years, or more often if requested by the parent or teacher or if conditions warrant, unless the parent and IEP team agree that a reevaluation is unnecessary.
A reevaluation determines:
- If the student continues to have a disability and continues to need special education and related services;
- Present levels of educational performance and educational needs;
- If additions or modifications are needed to the special education and related services in order to meet annual goals and to progress in the general curriculum.
The focus of the OT reevaluation is to gather information to help determine the student’s continued need for OT services in order to participate in school. The re-evaluation includes a review of previous evaluation data, student progress toward educational goals, and other evaluation tools/strategies selected to aide in the decision-making process.
All available information, assessment results, and results from independent evaluations are used by the team in the decision-making process regarding the student’s participation in special education and related services, including occupational therapy. Information from independent evaluations has no greater weight than any other team evaluation. A strong independent occupational therapy evaluation addresses the student’s performance in the educational setting considering the least restrictive (LRE) mandate. A credible evaluation includes, at minimum, observation of the child at school, interview of relevant team members, and consideration of past and current services.