Related Services: Steps to Success

1. Related Services: Steps to Success Heidi R Hull, OTD, MS OTR/L and Blake Walter, MS CCC-SLP Albemarle County Public Schools

2. Objectives • Recognize when related services direct and indirect are required • Differentiate if related services are aligned with the IEP • Defend your decision on why related services are needed or not

3. IDEA Sec. 300.34 Related services - General. Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. Related services also include school health services and school nurse services, social work services in schools, and parent counseling and training.

4. IDEA Occupational therapy— (i) Means services provided by a qualified occupational therapist; and (ii) Includes— (A) Improving, developing, or restoring functions impaired or lost through illness, injury, or deprivation; (B) Improving ability to perform tasks for independent functioning if functions are impaired or lost; and (C) Preventing, through early intervention, initial or further impairment or loss of function.

5. VDOE When occupational therapy is provided as a related service, it is meant to enhance a student's ability to function in an educational program. By focusing upon the skills of daily living, occupational therapists can often help individual students to function in the least restrictive environment. Generally, occupational therapists: • provide treatment to strengthen and develop fine motor functions; • focus on treatment of the small muscles, primarily those of the face, upper trunk, arms, and hands; and • improve the student's ability to perform tasks necessary for independent functioning, such as chewing, swallowing, placement of the tongue and mouth for speech formation, eye-hand coordination, and manual dexterity. http://www.doe.virginia.gov/special_ed/iep_instruct_svcs/related_services/occup-phys-therapy/index.shtml

6. Early OT Research Traditionally was direct treatments 1990’s consult/indirect was introduced 1996 occupational therapy school-based consultation (OTSBC) model Dunn (1990) Case-Smith & Cable (1996)

7. Early OT Research Reid, Chiu, Sinclair, Wehhrmann, & Zaseer (2006) Pretest/posttest 91 participants Completed - COPM, Teacher Awareness Scale, Client Feedback Questionnaire Results - teachers were satisfied when they and the students have positive results from the services

8. Educational Research Inclusion - first discussed in the educational realm in the early 1990’s Originally looked at in relation to development Myths about inclusion • Equality of opportunity is good for achieving inclusion • Standardization linked with equality means inclusion • Democracy means embracing inclusivity without boundaries (Portelli & Koneeny, 2011)

9. Early Educational Research Avramidis & Norwich (2002) No research demonstrating a positive attitude about inclusion from teachers Teacher-related variables: Gender Age/Years teaching Grade Level Contact with people with disabilities Training Teacher beliefs

10. Albemarle County Public Schools A brief walk through our county’s goals with regards to related services....

11. The Bridge Blake add images

19. Related Services: How do you know SPED won’t work?

21. Related Services: Look Fors ●Evidence of specialized instruction in IEP • Example: Goal, Service ●SPED Program attempted to deliver service/goal ●Evidence of need for related service ●Evidence of Least Restrictive Environment

22. Aligned Case Study Katy is an 4th grade student who is eligible to receive special education services as a student with a Specific Learning Disability in the area of reading. Her I.E.P. includes Specialized Instruction in reading for 45 minutes per day by the special education teacher. The student has an IEP Goal “Katy will increase her oral reading fluency to 81 words read correct by November 2019 (from her current score of 16).” (Specialized Instruction in IEP)

23. Misaligned Case Study Kevin is a 4 year old preschooler who is eligible to receive special education services as a student with an Other Health Impairment due to ADHD. Kevin became eligible for special education services through the preschool evaluation team due to a significant lack of impulse control which adversely impacted his educational performance. In the initial IEP, Occupational Therapy services were included as a related service for 120 minutes per month due to fine motor skill deficits from the initial assessment which impacted Kevin’s ability to complete prewriting activities.

24. Case Study Now it is your turn

25. Contextually based services Barriers Basic understanding of inclusion Trouble scheduling Rapport/relationship Parents want pull-out Strengths Increased knowledge and understanding of roles and responsibilities of team members (Case-Smith & Cable, 1996)

26. OT Research Campbell, Mossiuna, Rivard, Pollock (2012) • 7 OT’s followed over a year • Method - semi structured interviews • Outcome - positive connection to school more impact at the school more self-confidence

27. OT Research Morris (2013) • 12 collaborating dyads • Demographic survey, diary, self-reflective follow-up • Three common themes emerged - Joint decision making, effective communication, and increase feeling of respect • Common themes in the research too

28. Inclusion Strategies • Make time to explain the importance of inclusion • Find out the challenges or concerns that families and team members have • Explain the students strengths and challenges • Offer inclusion ideas and strategies gradually • Do therapy at times that work for most of the team (Elenko & Siegfried, 2018)

29. Inclusion Best practice in inclusive education requires access to and implementation of three major components: academic inclusion, social inclusion, physical inclusion. (VDOE, n.d.)

30. Inclusion • Increase in student engaging in learning • Increase in collaboration • Increase understanding from team members in decisions • Increase satisfaction in team members working with the students • Increase knowledge about OT (Laverdure, Cosbey, Gaylord, & LeCompte, 2017)

31. Take Aways • Remember Least Restrictive Environment • Communication with team members is paramount • This is a process • The student is benefitting for the specialized instruction Emails: hhull@k12albemarle.org and bwalter@k12albemarle.org

32. Big Thanks!! Thank you very much to Kevin Kirst and Katy Compel for allowing us to use the: • Related Services Decision Flow Chart • Framing routine • Related Services Look Fors

33. References Avramidis, E. & Norwich, B. (2002). Teachers’ attitudes towards integration, inclusion: a review of the literature. European Journal of Special Needs Education, 17:2, 129-147. Doi:10.1080/08856250210129056 Campbell, W., Missiuna, C., Rivard, L., Pollock, N. (2012). Support for everyone: Experiences of occupational therapist delivering a new model of school-based service. Canadian Journal Occupational Therapy, 79, 51-59. Case -Smith, J. & Cable, J. (1996). Perceptions of occupational therapists regarding service delivery models in school-based practice. Occupational Therapy Journal of Research, 16, 23-44.

34. References Dunn, W. (1990). A comparison of service provision models in school-based occupational therapy services: A pilot study. Occupational Therapy Journal of Research, 10(5), 300-320. Elenko, B. & Siefried, E. (2018). Promoting Inclusion Information and Strategies in Early Childhood. OT Practice, 23(5), 8-11. Individuals With Disabilities Education Act. (n.d.) Sec.300.34 Related Services. https://sites.ed.gov/idea/reds/b/a/300.34 Laverdure, P., Cosbey, J., Gaylord, H., & LeCompte, B. (2017). Providing Collaborative and Contextual Service in School Contexts and Environments. OT Practice, 22(15).

35. References Morris, M. (2013). Collaboration in Schools: Perspectives of occupational therapy and teacher dyads, Special Interest Section Quarterly: Early Intervention & School, 20(1). Portelli, J., & Koneey, P. (2018). Discussion paper: Inclusion education: Beyond Popular discourse. International Journal of Emotional Education, suppl. Special issue: Using Technology to Promote Mental, 10(1), 133-144. Reid, D., Chiu, T., Sinclair, G., Wehrmann, S., & Naseer, Z. (2006). Outcomes of an occupational therapy school-based consultation service for students with fine motor difficulties. The Canadian Journal of Occupational Therapy, 73(4), 225-35.

36. References Virginia Department of Education. (n.d.) Occupational therapy and physical therapy service. Retrieved March 4, 2019 http://www.doe.virginia.gov/special_ed/iep_instruct_svcs/related_services/occup-phys-therapy/index.shtml