Can my child receive Occupational Therapy in school without being
When a child is having difficulties in school he/she may be referred for
a full child study team evaluation to determine the child's eligibility for
special education and related services. Once evaluations are completed it
will be determined if the child requires classification and the appropriate
related services under IDEA. There may be situations when a child is found
not eligible for special education however the child may qualify for
specific services under a 504 plan.
What is the difference between center-based and school-based
occupational therapy services?
Occupational Therapy services provided in the school setting are very
specific and related to the child's educational performance. The therapist
providing the services is required by law to follow the Individualized
Education Program (IEP) and all treatment is educationally relevant.
Services provided in a center can include many areas of service and may
enhance performance in other life tasks.
What is the difference between direct and indirect occupational
Occupational therapy services can be delivered in a variety of ways
depending on the child's strengths and areas of difficulty. Direct
occupational therapy services consist of group or individual sessions
provided in class or out of class (pull out) where the child's specific
goals are addressed through hands on purposeful activity. Indirect services,
such as consultation and/or monitoring are provided to those children who
have achieved specific goals or who require more adaptation rather than
remediation. Consultation is an ongoing communication between the therapist,
parent, teacher and student where problem solving and trial of different
adaptations and environmental changes are used to allow a student to
function optimally in his/her educational environment without the need for
My child has terrible handwriting, does that mean he needs OT?
Handwriting is just one reason a child may be referred for occupational
therapy. Generally, handwriting alone is not indicative of a need for OT
services. Those skills that are needed for functional written communication
such as posture, fine motor skills, visual perceptual and visual motor
skills should be tested and treated if deficits are noted.
What is the difference between and OT and a COTA?
An OT is required to complete a bachelor or master's degree level
education and must pass an exam to receive his/her license to practice. A
COTA is required to complete an associate level of education and must also
pass an exam to receive his/her license to practice. Stronger emphasis on OT
theory and evaluation is included in the OTís education where the COTA's
educational emphasis is on activity analysis and treatment techniques.
Generally a COTA can provide the same level of occupational therapy
treatment as an OT but must always be directly supervised by an OT. A COTA
can contribute to evaluation, treatment and report writing.
Can the classroom teacher or classroom aide address areas of
difficulty cited by the OT?
Absolutely! It is the goal of any OT to have helpful treatment techniques
and adaptations follow the child throughout his/her school day so that the
child can be successful in all areas at all times. When possible it is
helpful if the classroom or 1:1 aide accompany the child to his/her therapy
sessions. As always, ongoing consultation with teachers and aides is a
necessity for successful follow through in the classroom.
Can my child get his/her sensory needs addressed in school?
Despite the space and equipment concerns in many schools these days, your
child's sensory needs can be addressed in school. Many OT's in school-based
practice do have specialty certifications in Sensory Integration beyond what
is addressed in their basic education. The therapist will often consult with
the gym teacher to share equipment and space, and if needed sensory diets
and other programs can be followed through by teachers and classroom aides.
What is Sensory Integration?
Sensory Integration is the neurological process that organizes
sensations from our bodies and from the environment and makes it possible
for us to use our bodies effectively during daily activities. We take in
sensory input every minute that we are awake. Our bodies take in this input,
process it and produce and appropriate response to the sensations (our
actions or behaviors). If there is "glitch" in this system, Sensory
Integration Dysfunction (DSI) may result, causing even simple activities
that we often take for granted to become challenging.
Will my child grow out of this?
Not necessarily. There are many children who, as their neurological
system matures and their skills develop, can work through some of their
sensory issues. For children with Sensory Integration Dysfunction, they are
most successful when their support network (parents, teachers, etc.) starts
"thinking sensory" and adapts their environment based on the childís sensory
preferences. So, the children donít "outgrow" their sensory issues, the
adults get better at working with them. With the help of an occupational
therapist trained in sensory integration theory, these children can be
confident and successful at many activities that interest them.
What does a school-based physical therapist do?
All physical therapists help people accomplish gross motor activities.
These are activities using large muscle groups, including walking, jumping,
lifting oneís arms to put on a coat etc.
The school therapist must work on school related goals. These may include
increasing access to school resources, mobility as it relates to the
classroom, or increasing a studentís ability to safely maneuver in the
Therapists strengthen weak muscles, help patients stretch, and improve a
patientís balance and coordination. Treatment techniques, such as heat/cold,
electrical stimulation, and biofeedback training are typically not provided.
Where and when does a school-based therapist work?
Therapy usually takes place where the child receives education.
Appropriate intervention may be provided in classrooms, hallways, gyms,
playgrounds, lunchrooms, or in a separate therapy room.
Therapy may be provided individually or in small groups by a therapist or
therapist assistant. Intervention may or may not be provided directly with
the child. Collaborating with educational staff to modify the child's
environment and daily school activities is always a part of school therapy.
What provisions entitle students to school-based physical therapy?
The provision of school-based therapy is governed by federal and state
laws (Individuals with Disabilities Education Act Amendment, PL 105-117).
Therapy is a related service to special education and is provided only if
the child needs therapy to function in the educational setting.
Who needs school-based physical therapy?
Students that have physical limitations preventing them from accessing
school resources may be entitled to receive school therapy.
The need for therapy is determined by the IEP team. School case managers,
teachers, and parents are a part of this team. When a member of the team
recommends an evaluation and the parent or legal guardian gives consent, a
therapist performs an initial evaluation. The evaluation report and
recommendations are presented to the team prior to the IEP meeting. The
team, in conjunction with the physical therapist, determines the amount,
frequency and duration of therapy. In the educational setting a physicianís
referral is often not needed in New Jersey.
Every year the IEP is updated. Changes to therapy are determined at the IEP
meeting. This may occur when the student is no longer eligible for special
education, when other members of the IEP Team can provide necessary
interventions, or when the child can perform school tasks without
therapeutic intervention. There may still be a need for community-based
Coordination deficits that do not impact a child's ability to physically
participate in all age appropriate school activities typically do not
require school-based therapy.
What can be done at Home?
Encourage a healthy, active lifestyle. In the United States, the number
of overweight children and adolescents has doubled. Elevated blood pressure
and type 2 diabetes related to poor nutrition are also on the rise. Make
exercise fun. Teach children about the importance of not smoking.
Comply with a home exercise program. Strengthening, coordination, balance
training, and especially stretching are most effective when performed daily.
Participation in extracurricular fitness programs or sports is often
helpful. Soccer, swimming, and karate all help improve coordination,
strength, and endurance. School based physical therapy often cannot formally
make this recommendation because participating in these programs is not
How do we begin the process of getting my child evaluated?
Trinitas Children's Therapy Services is a fee-for-service therapy center
and does not participate in any insurance plans. If you will be seeking
insurance reimbursement, call your insurance carrier to determine your out-of-network benefits for occupational therapy, physical therapy, speech-language therapy and/or Applied Behavior Analysis therapy. You may also need a doctor's prescription for the
evaluation and treatment. Next, you can schedule an appointment by calling
the Therapy Center Coordinator at 973-218?394, ext. 13. Once an appointment time
is scheduled, you will receive a packet of information in the mail that
includes an introduction to Trinitas, a developmental history to be filled
out, privacy statement, fee schedule and directions to our therapy center.
How do I get my insurance to reimburse services?
Different insurance companies have different procedures for submitting
claims. Trinitas Children's Therapy Services will provide you with all of
the diagnosis codes, procedure codes and facility information necessary to
submit a claim. Your insurance company may have a separate claim form that
needs to be completed. Their customer service number or website will assist
you in this process. The record of treatment we provide also indicates that
services were already paid for, so all reimbursement checks will be sent to
you by your insurance company.
How can I get my school system to pay for services?
Occasionally, school systems will agree to pay for "center-based" therapy
services under the Individuals with Disabilities Education Act (IDEA),
depending on the needs of the child. The services and goals must be directly
related to the child's ability to access their education
(educationally-relevant). A child may require therapy services that are more
"medically based;" however they do not have any functional difficulties in
their school environment. In this case, the school system may not be
responsible for providing these services. If you have any questions, you
should contact your Child Study Team at your childís school.
What types of workshops does Trinitas Children's Therapy Services offer?
Trinitas Children's Therapy Services has developed over 20 different
workshops on topics ranging from the development of fine and gross motor
skills to therapy services in the school system to sensory integration. We
are currently developing more workshops and will tailor any of our existing
workshops to meet your needs. Please ask about any topics in which you are
What is the fee for workshops?
The fee for workshops is based on several factors including the length of
the presentation, the number of participants, and the type of workshops. The
fee includes necessary handouts and information packets. Extras, including
materials for "make and take" activities and "goodie bags," may also be
included depending upon the topic.
Where do the workshops take place?
Trinitas Children's Therapy Services goes on the road to bring the
workshops to you. In some cases, workshops can take place in our Therapy Center, located in Springfield, NJ.
For whom are the workshops designed?
Trinitas Children's Therapy Services has designed workshops for a variety
of audiences including medical professionals, child study team members,
teachers, paraprofessionals, childcare providers and parents.
Where can I get more information about Trinitas Children's Therapy
Services workshops? Who do I contact if I am interested in setting up a
If you need more information or are interested in setting up a workshop
experience, please contact Christine German, Senior Occupational Therapist,
External Workshops and Seminars at 973-218-6394 x4012 or by email at