• Occupational Therapy


    What’s Required


    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 (Federal Regulations, §300.34).

    "Occupational Therapy (OT) is the therapeutic use of everyday life activities (occupations) with individuals or groups, to enhance or enable participating in roles, habits, and routines in the home, school, workplace community, and other settings. Occupational Therapy Practitioners are concerned with the result of participation and thus enable engagement through adaptations and modifications to the environment or objects within the environment when needed." (Occupational Therapy Practice Framework: Domain & Process, 3rd Edition (2014), American Journal of Occupational Therapy (AJOT), 68 (Supplement 1), S44)

    What We Do

    Referral Process

    When a campus or parent concern arises for a student in Special Education that involves occupational performance or participation in motor, process, or social interactions (AJOT, 2014, S.44) as they relate to the student's educational needs, the campus will consider whether a referral to occupational therapy is warranted. There are several circumstances under which a referral to occupational therapy may be generated.

    Students may be currently receiving special education services and demonstrate a lack of progress on a goal in an area that may require the addition of Occupational Therapy to allow the student to make satisfactory progress on that goal.

    Students may move into the district with Occupational Therapy as part of their Individual Education Plan (IEP).

    Students may be undergoing a Full and Individual Evaluation to determine eligibility for Special Education and OT is included as part of this process.

    It is determined at the Review of Existing Evaluation Data (REED) meeting that an updated assessment from occupational therapy is needed.

    For students currently receiving special education services the ARD Committee will:

    • Determine if there is an educational need for an OT Consult/Evaluation.

    If yes, a REED will be held and Parental Consent obtained to generate a Referral for an Occupational Therapy Consult/Evaluation which will be emailed to the campus Occupational Therapist.


    If no, move to the next step in the Referral Process as follows:

    • Use measurable data to determine if barriers are limiting the student's progress in the identified goals and objectives or if there are additional areas of difficulty for the student not previously identified.
    • Consider campus-based supports, including intervention strategies to benefit all students that are available to campus personnel on the OT/PT/MT Canvas Course that may address the identified barrier or additional area of difficulty.

    If data shows that the strategies have not resulted in adequate improvement in performance, and the barriers limiting student progress involve performance skills in the areas of fine motor impacting functional and/or self-help skills or social/behaviors impacting classroom participation, the campus team may request consult/evaluation from the campus Occupational Therapist.

    For students who move into the district with Occupational Therapy as part of their Individual Education Plan (IEP):

    • The student will be evaluated for 30 school days according to the provisions in the IEP from the previous school district.
    • The therapist will use this time to collect data needed to determine recommendations for occupational therapy services in the new setting. 

    Note:  Due to the Texas OT licensure rules that govern occupational therapy practice, the Therapist must have the following to provide occupational therapy services:

    • A current (accurate and within last three years) evaluation in hand
    • Goals that indicate OT support
    • OT time, frequency, and duration specified on the services page
    • For students with a medical condition (as defined in Texas OT Rule), a Physician Referral.

    Without these, the Therapist can only provide general intervention strategies.  If a current and adequate OT Evaluation does not come with the student's paperwork, the OT will update the student's present level of performance in their current educational setting and complete an OT Evaluation.

    For students who are currently undergoing a Full and Individual Evaluation to determine eligibility for Special Education:

    • The Evaluation Team may determine that information from Occupational Therapy is needed to determine if the related service of OT would be necessary for the event the student qualifies for Special Education.
    • If it is determined that Occupational Therapy is needed to participate in the Full and Individual Initial Evaluation, the Diagnostician or Speech Therapist will send a referral to occupational therapy utilizing the appropriate SPED referral form and email the campus Occupational Therapist.

    For students who are undergoing a Re-Evaluation Process and it is determined that an updated Occupational Therapy Evaluation is needed:

    The Diagnostician or Speech Therapist will procure parent permission for an OT Re-Evaluation and send a referral to occupational therapy utilizing the appropriate SPED referral form and email it to the campus Occupational Therapist.

    Evaluation Process

    Occupational Therapy Evaluation is a process "focused on finding out what a client wants and needs to do; determining what a client can do and has done; and identifying supports and barriers to health, well-being, and participation. The evaluation consists of the occupational profile and an analysis of occupational performance"(AJOT, 2014, pS13).

    In responding to the request for consultation/evaluation, the OT may do any or all of the following:

    • Review information such as work samples, report cards, outside evaluations, district evaluations, teacher observations, and previously attempted strategies.
    • Collaborate with the student's teacher(s) regarding the student's history and progress concerning the identified educational concern.
    • Observe the student in the educational setting during the time and in the environment(s) where the problem(s) occurs.

    If no additional support is indicated and it is determined that the area of concern can be addressed through general strategies (including classroom level interventions), the OT will complete the BISD OT Consultation Services form describing any observations/considerations and suggestions and/or follow-up that are recommended, review this information with the ARD Committee and provide this form to the campus Diagnostician or Speech Therapist to file in the audit folder.

    • If an OT Evaluation is indicated the OT will complete the evaluation and review with the ARD Committee.

    Service Delivery Models

    Student-specific services are provided in an integrated model to facilitate the implementation of the Individualized Educational Program (IEP) in the natural environment at school (including classrooms, hallways, cafeterias, gym, playground, etc.) Student-specific OT services are available for all students receiving special education services if an educational need is identified by the ARD Committee. OT services are provided as integrated support. Integrated OT service time may be used to work with the student in classroom or other school environments to determine appropriate strategies, interventions, and adapted equipment, and to train instructional staff on how and when to use strategies, interventions, and adapted equipment. The OT provider will participate with the collaborative team on the campus to assess the effectiveness of interventions and to revise/adapt interventions as needed.

    An Occupational Therapist is assigned to each campus in Birdville ISD and is available as a campus resource.