I am a COTA that is working in the school systems. I have recently had a problem with discharging a child. The child is in a moderately impaired class and has been receiving OT services since pre-school (7 years). Progress has been very limited, and is still working way below age level. However the teacher is new and is having trouble understanding the "plateau" concept. She does not understand how I can dismiss if they have made no progress and thinking I need to see them more to help with progress. The OTR and I feel that while fine motor is an issue the child’s decreased cognitive abilities are the primary reason for the delays. From talking to other people I feel we are keeping kids on way longer than most. So I guess what I need to know is when to discharge, after 1 year of no progression, is a few months each year over many years enough to continue???? HELP!!!!