The medical system is geared to
prevent and make better the effect of illness
the goal of the medical system is
to restore and promote health or trying to prevent an injury from happening, like arthritis
A ____________ leads the members of the team, other members can include
Physician -nurses, respiratory therapists, occupational / physical / speech therapy practitioners, and orthopedist.
you have to have a ______________ ___________ in a clinic, but not in a school system
physician referral
OTP Role is to
provide quality healthcare, prevention, wellness, and rehabilitation services
Medical settings include:
Hospital facilities: Neonatal intensive care units (NICU) Pediatric intensive care units (PICU) Sub acute or Inpatient units◦ Outpatient clinics◦ Long-term care facilities ◦ Home health
COTAS cant work with
early intervention children
goal of NICU
Goal of the NICU is to keep babies alive and to help them to stabilize their physiological states OT in the NICU is a highly specialized practice area, may require special certifications
Medicaid in GA is known as
Children intervention Services (CIS)
OTAS cannot bills for services if billing ____________
Medicaid
Policy and Procedures manual specifically includes verbiage stating
OTA, PTA, SLPA (aides or assistants) etc. are not allowed to provide services under the CIS Program.
Early intervention is what age groups
Birth - 3 YRS
School systems age is
3-21 YRS
early intervention - federal legislation as address the serviced provided to children since
1930s
1935 Title V of the Social Security Act provided
financial assistance for low income mothers and children and for crippled children
Easter Seals proved
funding for children with special needs in 1940-50s
What is the VERY important law made in 1975
Education for All Handicapped Children Act of 1975 (PL 94-142 ) (EHA)
What did the Education for all handicapped children act of 1975 mandate?
Mandated that free, appropriate public education (FAPE) be provided to all children, regardless of disability, in the least restrictive environment (LRE)
1986 EHA was ......
Amended it gave financial incentives to states to developEI programs
1997 EHA was renamed the ....
the Individualswith Disabilities Education Act (IDEA)
2004-IDEA was revised under the....
nameIndividuals with Disabilities Education Improvement Act
IDEA
0-3YR Old - part C - early intervention 3-21 Part B - if you are in a school system the school is required to service you until you are 21
Early Intervention IDEA part C: Eligibility in GA
called "babies cant wait" in GA- Eligibility in GA: Developmentally delayed by 2 standard deviations below the norm in one area1 and 1⁄2 standard deviations below the norm in two or more areaThey have established risk: they have diagnoses that typically result in developmental delays ie. CP, Down Syndrome
Can OTAs provide services in GA for babies cant wait
NOOTAs are not listed as qualified personnel in the EI policy manual
Who determines the goals in early intervention goals
professionals, the child, and the family determine the goals and services for the child.-Family only receives those services that they want.
What is IFSP
Individual Family Service Plan
Individual Family Service Plan is
- Developed by the team Outlines the services that will be put intoplace Must be completed and signed within 45days of the child's referral to EI, updated every 6 months(pg 307 in your book)
IFSP requires
- Present level of performance in the areas of development (physical/motor, language & communication, cognitive, social/emotional, and adaptive)- Families goals, resources, and needs- Measureable outcomes- Services to be provided- type, frequency, and duration- Where services will take place & how services will beincorporated into the family's natural environment- When services will begin and expected duration- Name of service coordinator- Transition statement (typically transition to the school system)
IFSP Team Members
Family Advocate (if requested by the family) EI Official Case Manager/Service Coordinator Service Providers◦ OT, PT, SLP, RBT, nursing, nutrition, psychological, vision, audiology, assistive technology, social worker, early intervention specialist, etc.
Educational System - school based therapy 3-21
Section 504 of the Rehabilitation Act in 1973 ◦ IDEA 2004-Part B Evaluation Link Assessment Results to Education Eligibility
What is the OT Role in school based therapy
- Work collaboratively with the IEP/504 team to make decisions about how to improve, develop, and restore a student's ability to perform school tasks as independently as possible- Develop adaptations to promote a student's success in the school setting- Therapy must be educationally relevant
IDEA Part B provides
the right to a free and appropriate education in the least restrictive environment
Least Restrictive Environment is
child should be in regular classroom as much as possible
OT is a Related Service, meaning
means that OT is provided if it is necessary for the child to benefit from the special education program (educationally relevant)-Necessary if the child requires services to access the curriculum at the same level as their non-disabled peers
Occupational therapy is a Direct Access profession, this means
This means that anyone can refer a child for OT services and legally OT's do not have to have a physician's order to provide OT services
Special education services is
A disability exists that impacts a child's ability tolearn
504 services covers
- RTIkids with disabilities that do not need specialized instruction, but do need accommodations- OT services if the child's condition "substantially limits one or more major life activities
RTI services
tier 1 - teacher intervention tier 2 - when OT may come in, OT does screening and gives teacher pointers to work with child tier 3 - Refer them to OT- legally the kids are suppose to sit at each tier for 60 school days -if have grades c or better cant get IEP
Who can refer a child to OT?
School teachers Parents Other therapists They can all refer a student for an OT evaluation
Once a referral is made the team......
Team conducts evaluation to determine eligibility Based on findings, student may qualify for OT services under an IEP or a 504 plan OT must link assessment results to academic performance
what is IEP (individual education program)
Legal document which governs special educationservices in the school system IEP team consist of:◦ Regular teacher◦ Special education teacher◦ Therapists(OT,Speech,PT,etc.) ◦ School system rep◦ School psychologist◦ Family Parents must be notified of the IEP meeting and they have the right to appeal the IEP. Must be updated annually Reevaluation of child occurs every 3 years
IEP Required Components
Parental Concerns Statement ofcommunication needs of a child w/ vision or hearing deficits Evaluation results Strengths Present levels ofeducational performance (sometimes referred to as PLOP or PLAAFP) Goals, objectives, and how to measure Beginning and ending date of IEP Services provided◦ Location of services◦ Service provider◦ Frequency of services ◦ Duration of services Consideration of behavior issues Report of progress towards previous goals & objectives Transitional services (age 14 and older) Assistive technology
Types of Therapy Provided
- Fine motor skills development needed for classroom activities Handwriting skills development Classroom modification ADL skills needed in the classroom Sensory integration skills needed for educational activities Adapting positioning devices Evaluating and recommending assistivetechnology devices Treatment designed to help the child transition to the world after high school
Tips for working with parents
- Parents know their child!- Present information in layman's terms- Ask what the parent's hope to achieve from themeeting- Begin with talking about the child's strengths- Try to speak to parents' before an evaluation- Ask parents what works/does not work at home- Be clear about what has been tried in the clinic/classroom that worked/didn't work- Organize problem list in the areas that are going to be immediately targeted- Offer individualized suggestions for the classroom/home- Follow up with parents...both on the strengths and weaknesses
Tips for working with Teachers
- Remember OT job is to help the child function in the classroom- Spend time in the classroom- Ask teacher what he/she sees as the problem forthe child- Prioritize your strategies for the teacher- Provide the teacher with short written strategies- Respect the teacher's time- Be a resource for the teacher- Provide solutions to the teacher
OT series is limited and practitioners might end up doing therapy in.....
in closets, in the gym, or on the auditorium stage. We often have to negotiate for space-It is not uncommon for one practitioner to provide services for more than one school or school districts