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school based OT

Last post 03-11-2008, 7:33 PM by Kirsten Evensen. 12 replies.
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  •  09-20-2007, 2:22 PM

    school based OT


    Hello all....I have a question....it could be ethical.....so I need some help, or just to be pointed in the right direction. I work for the board of education at a public school system. We (all related service providers) are still required to have our own goals on the IEP for the students that we service. As an OT/PT team, we are aware that we should NOT have our own goals, due to being "related service providers" and we should be working with the goals of the qualifying service providers (i.e., we can focus our treatment around the goals on the IEP from the special education teachers such as writing, etc.). My question to you all is this: do you have your own goals on the IEP under "O.T." or do you follow the currenct IEP under the main goals. Thanks for all your help.
  •  09-20-2007, 4:24 PM

    RE:school based OT

    As a contractor I provide related services in a school and have had the same question, however have always had my own goals on the IEP's. However, there are many times where at the top of the page of the Language Arts goals for example where it states who is responsible I will have them list me so that I can support those goals as well.  I don't really see it as a huge problem right now, and actually I think it makes it easier to discharge kids when they have met the OT goals.  If they still have a ways to go on a LA goal for example that I am supporting but it is not related to a OT deficit, what justification would we have to d/c the kid from services.  I could see it getting really sticky.  Just some thoughts, but it does seem that many places are still requiring OT's and PT's to have their own individual goals.  You are not alone.

     

     


    vicenzagirl
  •  11-21-2007, 1:51 PM

    Re: school based OT

    I always write OT related goals that should be addressed by both me and classroom staff.  Therefore, in the section "who's responsible" I put "OT/classroom staff" as I am primarily responsible for the documentation of the goal and provide the consultation/recommendations to the classroom staff from the OT perspective.
    school OT
  •  11-21-2007, 2:12 PM

    Re: school based OT

    No we do not write OT goals.  There is one exception in which I am working with an orthopedically impaired student on self feeding with adapted utensils.  However, our school district does ask us to state the areas that OT and PT are supporting on the service sheet.  So we write "Occupational Therapy for fine motor", or "Occupational therapy for access to technology", or "Occupational therapy for functional school skills" to help get a quick overview of areas of performance that OT is supporting.  It may be  that we are supporting many areas, but we list all areas on the service sheet under related services.
  •  11-21-2007, 2:33 PM

    Re: school based OT

    I recently asked that question to the OT who is a member of the NC Department of Public Instruction Special Education Division at our annual state conference.  She indicated that here we are to have our own goals on the IEP because we are allowed to bill Medicaid for our services.  Our OT IEP serves as the treatment plan that is signed by the student's physician and which then permits Medicaid billing.  There was a breakout point during the 2 day conference where OT's discussed IEP goals.  That group then reported to the rest of us.  They indicated the same thing and I didn't hear any of the OT's say that they weren't writing their own goal pages.  But I did learn that I am to use the standard course of study to find the appropriate grade level goals to work on, which would support the goals that the other members of the IEP team would have.  Individual LEA's are allowed to do things in different ways though, and I think that is what causes us so much confusion when we try to compare our practices.  I think it would be great if we could all use one system.
  •  11-21-2007, 6:19 PM

    Re: school based OT

    In Florida we are working very hard toward Integrated IEP's. We are educating the teachers/staff to write goals that OT's can relate to. If a teacher is writing a goal and there is nothing that OT can work on then does OT really need to be involved? Remember it is supposed to be educationally relevant not medical model.

     My thinking is: if we are a RELATED service, then we need to RELATE to what the teacher needs them to do. So many teachers tend to feel that it is the "OT goal" and dont work on these goals as they did not write them (even though their name is in the "person responsbile " area as well as the OT).

    We need to start to unite our efforts to have the goal generalized in the classroom. It is all very well that the OT can get Johnny to print his name legibly, but does the teacher see the same thing? Does he/she use the same methods and are they buying into the therapy methods we are using?  We also need to be careful that we are not writing modalities rather than functional educationally related goals. I would guess most of the OT written goals are modalities.       

    So many times I have heard a teacher saying, I dont know if he has achieved this goal. That is so wrong.

      I think it needs to be a united front... the teacher should write the goal with our input, we should work on the goals together, educating the teacher how best to have the child adapt or gain function, and the teacher should write the "report card progress notes," and we can write our "medicaid" supported notes.

    I hope this doesnt sound harsh, but I really feel strongly about this.

     What do you all think?    

  •  11-21-2007, 6:50 PM

    Re: school based OT

    This student has an OI classification and is functioning at grade level but reportedly experiences pain and decreased endurance with writing activities. The assistive technology team is providing support for typing, solo software, tape recorder for notes, emailed homework assignments etc. The resource teacher is providing consult for shortened work assignments etc to the general ed teacher. Can OT consult services be provided without completing an evaluation and listed on the IEP under "Program Modifications or Supports for School Personnel? The "team " decided to implement OT as a consult in this fashion without my knowledge and now I am being called on the carpet for not providing consult services. Any comments or suggestions? Thanks
  •  11-24-2007, 8:26 AM

    Re: school based OT

    I hope that over time they will see what an asset you are to the team and include you in on the process from the beginning.  I have never been in this situation, but here is what I think I would do.  I would provide them with general information about how OT might help in such a situation.  I would give them different suggestions based on different frames of reference because since you haven't evaluated you do not know the possible cause.  For instance, I would give ideas that would be appropriate if the issue was related to a neuromuscular cause.  I would give them ideas that would be appropriate if the cause was related to a biomechanical issue.  I would give them other ideas that would be appropriate if the cause was due to a psycho-social issue.  I may even think of ideas in case the cause was a developmental delay or lack of exposure.  But I would hope that when they see that I can't give specifically helpful information because I wasn't involved early enough and not given the opportunity to perform an evaluation that they would realize that they made a mistake and take actions to correct it.  Perhaps they would realize that issues may seem simple at times but that they shouldn't make assumptions and give the OT the opportunity to use his or her professional evaluation skills to provide the team with specific and functional suggestions.  I hope this helps.
  •  11-24-2007, 11:46 AM

    Re: school based OT

    Barbara Chandler wrote an excellent article on this topic in the 4/16/07 issue of ADVANCE for Occupational Therapy Practitioners magazine, titled "Getting Good Information about Best Practice".  To quote her, "..there are no OT goals on an IEP....If you're still writing OT goals, stop."  Although I have since corresponded directly with her and found that some states (e.g. Washington) have their own guidelines which make it possible to have OT goals on an IEP, so the bottom line is be familiar with your own state rules and regulations for school district practice. 
  •  11-24-2007, 4:45 PM

    Re: school based OT

    We have our own goals for ot and pt we are part of the team and are mandated by the iep to provide service for each of our students.  we f/u with progress and modify goals as needed.  we also work with the other team members to address the childs needs.
  •  11-27-2007, 5:59 PM

    Re: school based OT

    I believe an eval would need to be completed to know what you were consulting on and to warrant it, the "team' cannot determine this for you.

     

  •  12-11-2007, 1:08 PM

    Re: school based OT

    I work in the school system in TN and we do not have our own goals but sometimes they teacher asks for our in input
  •  03-11-2008, 7:33 PM

    Re: school based OT

    I am in a district where we are just moving from writing our own goals to supporting educational goals.  My question is, how do you still track your own interventions, progress, data, etc. without the traditional goals?  I am having a difficult time figuring out how I would arrive at an IEP meeting and provide any objective information or data.  I feel like OT suffers from a perception of not having research driven data behind us as it is and fear that I will lose gains I have made in my district.  Can anyone help?  Perhaps an example of goal sheets or educational goals you support?

    Thanks