california department of education guidelines for occupational ...

1. California Department of EducationGuidelines forOccupational Therapy and Physical Therapy in California Public Schools

2. The process began in ??? Primarily because the Original Guidelines that were published in 1996 had been out of date for some time. IDEA had passed and been reauthorized and altered and state laws and regulations changed in accordance. Another major factor was that occupational therapist were required to hold a state license.The process began in ??? Primarily because the Original Guidelines that were published in 1996 had been out of date for some time. IDEA had passed and been reauthorized and altered and state laws and regulations changed in accordance. Another major factor was that occupational therapist were required to hold a state license.

3. Committee Created Members were representative of school–based practice in California Northern and Southern California Urban and rural practice settings Diverse areas of expertise and practice Clinicians, administrators, educators and researchers Several OT parents of children with special needs Committee was created of over 25 OT’s and PT’s from different areas in the state and with a variety of expertise and backgrounds. Several of the OT’s were also parents of children with special needs themselves.Committee was created of over 25 OT’s and PT’s from different areas in the state and with a variety of expertise and backgrounds. Several of the OT’s were also parents of children with special needs themselves.

4. Review Process CDE Special Education Division Reviewed by CDE Superintendent of Education Reviewed by CDE legal department SELPA Directors, Administrators, Attorneys Members of OT and PT practice community USC, San Jose State, Loma Linda, UCLA AOTA, APTA OTAC, CAPTA USC and UCLA University Centers for Excellence in Developmental Disabilities (UCEDD) The review process was the most arduous of the entire process and involved…The review process was the most arduous of the entire process and involved…

5. Guidelines for OT and PTSecond Edition 2010 Based on Federal and State Regulations California Department of Education Mission Vision State Performance Plan OT and PT Licensure and Practice Frameworks

6. The beginning has a table of contents of course, and a nice introduction from Jack O’Connell and statement of acknowledgements and a list of contributors. The end has a glossary of terms and a list of Frequently Asked Questions. The bulk of the contents are divided into 4 main sections with 2 to 4 chapters in each section.The beginning has a table of contents of course, and a nice introduction from Jack O’Connell and statement of acknowledgements and a list of contributors. The end has a glossary of terms and a list of Frequently Asked Questions. The bulk of the contents are divided into 4 main sections with 2 to 4 chapters in each section.

7. Section I Overview and Framework Chapter 1 Mission, Beliefs, and Purpose Chapter 2 Definitions, Qualifications, and Functions Chapter 3 Evidence-Based Practice and Accountability Section I contains an overview of therapy and the framework that organizes our practice.Section I contains an overview of therapy and the framework that organizes our practice.

8. Chapter 1 Mission, Beliefs, and Purpose Chapter One explains the mission, beliefs and purposes of both occupational therapy and physical therapy being provided to children in an educational environment. To help explain this clearly a new model was developed based on the framework and beliefs adopted by the World Health Organization and the national associations for both occupational therapists and physical therapists. The core elements of the Model of Educational Framework for Child Success include the child performing within the context of the school environment, accessing the curriculum and moving toward positive postsecondary outcomes. Intervention strategies are based on team collaboration, evidence-based practice and ongoing progress monitoring.Chapter One explains the mission, beliefs and purposes of both occupational therapy and physical therapy being provided to children in an educational environment. To help explain this clearly a new model was developed based on the framework and beliefs adopted by the World Health Organization and the national associations for both occupational therapists and physical therapists. The core elements of the Model of Educational Framework for Child Success include the child performing within the context of the school environment, accessing the curriculum and moving toward positive postsecondary outcomes. Intervention strategies are based on team collaboration, evidence-based practice and ongoing progress monitoring.

9. Chapter 2 Definitions, Qualifications, and Functions OCCUPATIONAL THERAPY California Business and Professions Code Section 2570.2 (k) states:Practice of occupational therapy means: the therapeutic use of purposeful and meaningful goal- directed activities (occupations) which engage the individual's body and mind in meaningful, organized, and self-directed actions that maximize independence, prevent or minimize disability, and maintain health. PHYSICAL THERAPY The California Physical Therapy Practice Act, in Business and Professions Code Section 2620, states:Physical therapy means the art and science of physical or corrective rehabilitation or of physical or corrective treatment of any bodily or mental condition of any person by the use of the physical, chemical, and other properties of heat, light, water, electricity, sound, massage, and active, passive, and resistive exercise, and shall include physical therapy evaluation, treatment planning, instruction and consultative services….. In general the role of occupational therapists and physical therapists in an educational setting is to support a child’s ability to have access to and make progress in their educational program. Chapter 2 goes into more detail about the specific definitions of each profession including the legal definitions from the California Business and Professions Code as well an explanation of the qualifications of each.In general the role of occupational therapists and physical therapists in an educational setting is to support a child’s ability to have access to and make progress in their educational program. Chapter 2 goes into more detail about the specific definitions of each profession including the legal definitions from the California Business and Professions Code as well an explanation of the qualifications of each.

10. Chapter 3 Evidence Based Practice and Accountability Scientifically based intervention Data driven services Progress monitoring The law states that methods and instructional strategies are to be based on evidence-based practice. Chapter 3 provides information to help practitioners to use evidenced base intervention strategies and monitor progress in a systematic and efficient manner. The law states that methods and instructional strategies are to be based on evidence-based practice. Chapter 3 provides information to help practitioners to use evidenced base intervention strategies and monitor progress in a systematic and efficient manner.

11. Section II Laws and Scope of Practice Chapter 4 Laws, Regulations, and Policies Chapter 5 Scope of Practice of Occupational Therapy and Physical Therapy in California Section II contains the important foundational information about the laws that guide us.Section II contains the important foundational information about the laws that guide us.

12. Chapter 4Laws, Regulations and Policies IDEA 2004: Parts A, B, C, and D NCLB 2001 Section 504 Rehabilitation Act Interagency Responsibilities: Gov Code 7570 Specifically Chapter 4 Highlights sections related to occupational therapy and physical therapy from IDEA Parts, A, B, C, and D; from No Child Left Behind Legislation; Section 504 of the Rehabilitation Act and also reviews interagency responsibilities that affect us so much here in California. These include the Department of Mental Health that provides services under AB 3632; Department of Health Care Services that provides funding through MediCal and overseas California Children Services - CCS; Department of Social Services who at times controls the educational rights of children and provides residential placements. And Department of Developmental Services who provides early intervention services and is intimately involved with transition into the school system when children turn 3. Chapter 4 also contains a nice chart that summarizes the changes in federal regulations from the most recent reauthorization of IDEA beginning on page 45.Specifically Chapter 4 Highlights sections related to occupational therapy and physical therapy from IDEA Parts, A, B, C, and D; from No Child Left Behind Legislation; Section 504 of the Rehabilitation Act and also reviews interagency responsibilities that affect us so much here in California. These include the Department of Mental Health that provides services under AB 3632; Department of Health Care Services that provides funding through MediCal and overseas California Children Services - CCS; Department of Social Services who at times controls the educational rights of children and provides residential placements. And Department of Developmental Services who provides early intervention services and is intimately involved with transition into the school system when children turn 3. Chapter 4 also contains a nice chart that summarizes the changes in federal regulations from the most recent reauthorization of IDEA beginning on page 45.

13. Chapter 5 Scope of Practice Table 5.1 Summary of State Requirements For OT and PT Chapter 5 describes the specific scope of practice of each profession. It includes this Table that summarizes what the state requires in the licensure law. LISA - Aid issue….. Show Table 5.1 from PDFChapter 5 describes the specific scope of practice of each profession. It includes this Table that summarizes what the state requires in the licensure law. LISA - Aid issue….. Show Table 5.1 from PDF

14. Section IIITherapy Services in the Educational Setting Chapter 6 Early Intervention Services for Infants and Toddlers Part C Ages 0-3 Chapter 7 Services for School Age Children Part B Ages 3 - 22 Chapter 8 Secondary Transition for Youths Ages 14-22 Chapter 9 Assistive Technology and Universal Design Section III includes the chapters related to implementation of services.Section III includes the chapters related to implementation of services.

15. LEA for solely low incidence OT and PT are primary service providers Chapter 6 starts off with the early intervention services meaning services for infants and toddlers from birth to 3 years of age. IDEA covers this in Part C. California has different agencies that provide therapy services to these children primarily Regional Centers, but schools districts provide the services for the students with low incidence disabilities including DHH, VI, and SOI. Within this age group OT and PT are considered primary service providers.Chapter 6 starts off with the early intervention services meaning services for infants and toddlers from birth to 3 years of age. IDEA covers this in Part C. California has different agencies that provide therapy services to these children primarily Regional Centers, but schools districts provide the services for the students with low incidence disabilities including DHH, VI, and SOI. Within this age group OT and PT are considered primary service providers.

16. Chapter 7 Services for School Age Children [Ages 3-22] Part B OT and PT Role in Response to Instruction and Intervention OT and PT as related services Table 7.1 and Table 7.2 contain examples of therapy in the educational setting Table 7.3 shows examples of how therapy interfaces with State Standards

18. Assessments What assessment instruments are considered best practice? How are OT’s assessing the need for sensory motor integration? These are some questions generated by your group related to Assessments. The general answers to these are here in Chapter 7. …These are some questions generated by your group related to Assessments. The general answers to these are here in Chapter 7. …

19. Goals and Objectives Can you share some examples of goals and objectives written by OT’s? Is there a trend for OT’s to teach handwriting skills? Attached to your handouts is a list of some sample goals that Valerie gave out to OT’s during a workshop on how to write appropriate IEP goals. It was developed prior to the adoption of the new content standards. OTAC is planning to have a goal bank available for it’s members on it’s website so that will be a resource that the OT’s in your districts can use. Since OT’s are a related service they rarely work on IEP goals in isolation. For example if the IEP team has determined that a child has difficulty writing a paragraph, the IEP goal may be to write a 5 sentence paragraph… The OT might help the child make progress toward this goal by working on the underlying foundational skills of fine motor and visual perception so that the child’s penmanship will be legible with spaces between the words. The teacher will be working on sentence structure, punctuation, and other conventions. The behavior specialist will develop a positive reward system for when the child attempts to write as directed. Another somewhat related questions is are OT’s handwriting teachers. Unfortunately OT’s have become the handwriting experts however it is not the intent of OT’s to be teachers of anything. Many teachers tell us that they were not trained in teaching handwriting or say that they do not have time to include it in their curriculum. I recently had a principal at one elementary school state that because there are more important content standards to work on and they don’t have time to address all of them they have chosen not to teach cursive writing at any grade at their school.Attached to your handouts is a list of some sample goals that Valerie gave out to OT’s during a workshop on how to write appropriate IEP goals. It was developed prior to the adoption of the new content standards. OTAC is planning to have a goal bank available for it’s members on it’s website so that will be a resource that the OT’s in your districts can use. Since OT’s are a related service they rarely work on IEP goals in isolation. For example if the IEP team has determined that a child has difficulty writing a paragraph, the IEP goal may be to write a 5 sentence paragraph… The OT might help the child make progress toward this goal by working on the underlying foundational skills of fine motor and visual perception so that the child’s penmanship will be legible with spaces between the words. The teacher will be working on sentence structure, punctuation, and other conventions. The behavior specialist will develop a positive reward system for when the child attempts to write as directed. Another somewhat related questions is are OT’s handwriting teachers. Unfortunately OT’s have become the handwriting experts however it is not the intent of OT’s to be teachers of anything. Many teachers tell us that they were not trained in teaching handwriting or say that they do not have time to include it in their curriculum. I recently had a principal at one elementary school state that because there are more important content standards to work on and they don’t have time to address all of them they have chosen not to teach cursive writing at any grade at their school.

20. Interventions What is the difference between educational and medical necessary OT and PT? Is OT and/or PT a stand alone service? If yes, how does one demonstrate that there would be an adverse impact without it? What is the rationale and standard level of care/treatment/service level for providing OT? 1xweek 2x, 5x, etc.? OT’s use clinical reasoning to develop treatment goals, treatment plans of intervention, and how often the service needs to be provide to make progress. Research supports that if the treatment plan includes making changes to the nervous system then twice per week is necessary to maintain what has been learned by the brain. Once per week is typically chosen if it is a skill that needs to be taught and then practiced by the child, possibly under the supervision of other adults over the course of a week. At the end of the week the OT determines whether more practice is necessary, or if a new strategy should be tried, or if the child is ready to learn the next skill. Some research supports providing intensive treatment for a shorter amount of time such as 5 day a week for 2 to 4 weeks instead of once per week over the course of a school year. That would be for skills that would best be taught with accurate repetition and then once learned are ingrained and be monitored to make sure the child continues to use the skill. OT’s use clinical reasoning to develop treatment goals, treatment plans of intervention, and how often the service needs to be provide to make progress. Research supports that if the treatment plan includes making changes to the nervous system then twice per week is necessary to maintain what has been learned by the brain. Once per week is typically chosen if it is a skill that needs to be taught and then practiced by the child, possibly under the supervision of other adults over the course of a week. At the end of the week the OT determines whether more practice is necessary, or if a new strategy should be tried, or if the child is ready to learn the next skill. Some research supports providing intensive treatment for a shorter amount of time such as 5 day a week for 2 to 4 weeks instead of once per week over the course of a school year. That would be for skills that would best be taught with accurate repetition and then once learned are ingrained and be monitored to make sure the child continues to use the skill.

21. Chapter 8 Secondary Transition [Ages 14-22] Self-Determination Strategies for success Adaptive and performance skill development Equipment

22. Chapter 9 Assistive Technology and Universal Design OT and PT role in AT: Physical access for low incidence OI Modifications and accommodations Independence and access to curriculum

23. Section IV Administration of Therapy Services Chapter 10 Fiscal Considerations for Therapy Programs Chapter 11 Management of Therapy Services in the Educational Setting The final section contains the chapters that are probably of most interest to you as administrators since they provide guidelines for developing new programs, the costs Let’s first answer that last or the questions that you provided and then we will open it up to any other questions you have.The final section contains the chapters that are probably of most interest to you as administrators since they provide guidelines for developing new programs, the costs Let’s first answer that last or the questions that you provided and then we will open it up to any other questions you have.

24. Funding When the schools provide LEA MediCal billing…how does one get a prescription for educationally necessary OT?

25. Positive Post-secondary Outcomes

26. THANK YOU!