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School-based therapy is considered when a student’s needs are affecting their ability to participate, communicate, move safely, or engage in learning. An evaluation helps the school team determine whether specialized OT, PT, or speech-language support is needed to help the student access and benefit from their education.
OT (Occupational Therapy): Fine motor skills, sensory needs, visual-motor skills, self-help skills & classroom participation
PT (Physical Therapy): Mobility, strength, balance, coordination & safe access to the school environment
SLP (Speech-Language Pathology): Speech, language, communication, fluency & social communication
When a student is having difficulty communicating, moving safely around school, completing classroom tasks, regulating sensory input, or participating in everyday school activities, families and educators may begin asking an important question:
The answer depends on more than whether a student has a diagnosis or struggles with a particular skill.
Under the Individuals with Disabilities Education Act (IDEA), occupational therapy, physical therapy, and speech-language pathology are recognized as related services that may be provided to help an eligible student benefit from special education.
In Pennsylvania, determining whether a student qualifies involves evaluation, collaboration among the educational team and family, and consideration of the student’s individual educational needs.
School-based therapy is designed around the student’s ability to participate in and benefit from their educational program.
This is an important distinction from outpatient or medical therapy.
A school-based occupational therapist (OT) helps students participate in school-related occupations and activities. Depending on the student’s needs, this may include:
AOTA describes school-based occupational therapy as supporting participation in activities such as academics, social participation, self-care, organization, and learning.
School-based physical therapy addresses functional movement and participation within the educational environment.
A school-based PT may support:
PaTTAN notes that school-based PT can address motor function, mobility, classroom and playground participation, self-help skills, social participation, assistive technology, and other functional needs.
School-based speech-language pathologists support communication needs that affect a student’s educational participation.
Services may address:
IDEA defines speech-language pathology as a related service that includes identification, diagnosis and appraisal of speech or language impairments and provision of speech and language services.
One of the most common misconceptions about school-based OT, PT and speech therapy is that a medical diagnosis automatically qualifies a student for services.
It does not.
Instead, the educational team must consider whether the student meets the applicable special education eligibility requirements and whether special education and/or related services are needed because of the student’s educational needs.
The exact eligibility determination is made by the appropriate educational team based on the student’s evaluation and applicable requirements.
A concern may be identified by:
For example, a teacher may notice that a student cannot independently navigate the school building because of mobility limitations. Another student may have difficulty communicating their needs to teachers and peers.
These observations can lead to a discussion about whether an evaluation is appropriate.
Parents and schools can initiate the evaluation process.
IDEA states that either a parent or public agency may initiate a request for an initial evaluation to determine whether a child has a disability.
Pennsylvania’s PaTTAN resources also explain that parents can request a referral for school-based physical therapy and that the educational team can make a referral as well.
A referral does not automatically mean a student will receive therapy. It begins the process of determining whether additional evaluation is needed.
A school-based therapy evaluation looks at the student’s needs in the context of the educational environment.
IDEA requires evaluations to use a variety of assessment tools and strategies and states that a single assessment cannot be used as the sole criterion for determining eligibility or an appropriate educational program.
The evaluation team may consider:
The goal is to develop a comprehensive picture of the student’s strengths and needs.
IDEA requires eligibility decisions to be made by a group of qualified professionals and the student’s parents.
The team must consider information from multiple sources rather than relying on a single test or observation.
This means a student who has difficulty with handwriting, for example, does not automatically qualify for school-based OT simply because an OT identifies a fine motor weakness.
The team considers whether that need has an educational impact and whether occupational therapy is necessary for the student to benefit from their educational program.
If a student is found eligible for special education, the team develops an Individualized Education Program (IEP).
The IEP may include related services such as:
IDEA identifies OT, PT, and speech-language pathology among the services that may qualify as related services.
Pennsylvania also recognizes OT, PT, and speech-language services as related services documented in students’ IEPs.
Not necessarily.
A medical diagnosis can be useful information for an educational team, but school-based therapy eligibility is an educational determination.
The key question is whether the student’s disability creates educational needs that require special education and/or related services.
This is why school-based therapy is different from outpatient therapy.
A child may receive outpatient OT to address a medical or developmental condition while also receiving school-based OT for educational needs. In other cases, a child may receive one type of service but not the other.
AOTA emphasizes that school-based OT and medically based OT have different goals and settings, even though both are designed to help children function and participate more independently.
Yes.
Parents are essential members of the evaluation and IEP process.
IDEA permits a parent to request an initial evaluation when they suspect their child may have a disability.
Parents can share concerns about:
If you have concerns about your child’s ability to access their education, begin by communicating with the child’s teacher or school team and asking about the evaluation process.
Pennsylvania special education requirements establish timelines for completing evaluations.
Generally, an initial evaluation must be completed and the evaluation report provided to parents within 60 calendar days after the agency receives written parental consent, with Pennsylvania’s applicable exclusion for the summer period.
PaTTAN’s current PT family resource likewise states that the evaluation report must be presented to parents within 60 calendar days of receiving parental consent.
Because individual circumstances can affect the process, families should speak with their school district regarding the specific timeline applicable to their child.
Once the evaluation process is complete and the team determines that the student is eligible and requires related services, the IEP team develops an individualized plan.
For school-based therapy, this may include decisions about:
The goal is to provide services that support meaningful participation in the student’s educational program.
PaTTAN’s guidance describes the IEP process as a collaborative process involving parents, educators, related service providers, and other appropriate team members.
At AOT, Inc., we provide school-based occupational therapy, physical therapy, and speech-language services to schools and students throughout Southwestern Pennsylvania.
Our approach centers on collaboration, individualized care, and practical strategies that help students participate meaningfully in their educational environment.
For schools looking for experienced school-based OT, PT and SLP services in Pennsylvania, AOT can help build a therapy program that supports students, educators, and school communities.
Professional References