Explain to me why OT is considered differently than other services

[HighSchoolParent]

My son has Developmental Coordination Disorder which results in fine motor delays, motor planning challenges, and visual and auditory processing deficits. OT is extremely helpful, and it is the only thing that is helpful. There is no medication available.

The way this affects him in school is that he cannot do any activity that requires motor planning: crafts, puzzles, building projects, drawing. Art and vocational classes are inaccessible to him, science labs are difficult - he relies on his partners a lot. His handwriting is messy and painful.

His visual processing is below the 1st percentile. He can read well but only in short sessions because his eyes fatigue.

His school district has known his diagnosis since preschool (he is in 9th grade) and have always refused to provide any kind of OT services. The OT testing they have done as part of has flagged deficit areas. They used some lingo to explain why they will not provide OT services. I cannot remember exactly what they said, but it seemed to boil down to: OT is in a different category of service and they don't have to provide it. It took a lot effort (and an advocate/lawyer) to allow accommodations: being able to type, being able to use digital images instead of drawing, not being penalized for not completing tasks that require complex motor planning.

He does receive OT privately, but his health insurance won't approve OT for any goals that seem academic.

When he had swallowing issues his school provided SLP services, even though those didn't affect him academically. But there is no OT for issues that do affect him academically. Can you help me understand why?

 

 

[JSD24]

I wish I had an answer for you.  This references DCD (your child's diagnosis & OT at school:  https://www.understood.org/en/articles/occupational-therapy-what-you-need-to-know.  I remember some "rule" about no OT unless another service is also needed but I'm not sure where I heard this.  Does your child have transition goals?  What about leisure goals?  You might be able to get OT with this sort of goal.  (Given you needed a lawyer to get accommodations, my guess is that the school is being very stubborn about this.  Is there case law on this?  You might be able to do some digging on Google Scholar and find cases where it was okayed.)  What your school is saying might be based on what your state has said about OT at school:  https://www.wrightslaw.com/blog/can-occupational-therapy-ot-be-a-stand-alone-service/

[Jenna]

To qualify for an IEP, a child's education has to be adversely affected by one of the 13 disability categories listed in the IDEA. If your child has an IEP, the district is required to evaluate them in all areas of suspected disability, so see what the district said about why your child doesn't qualify for OT. If it's been a while since an OT eval was completed by the district and your child has an IEP, you can always ask for the district to do another eval in this area. You could also consider getting an IEE if the district recently performed an OT eval and you disagree with it. See https://adayinourshoes.com/iee-independent-education-evaluation/ for more on IEEs. 

[HighSchoolParent]

He qualified for an IEP under OHI due to his DCD, specifically the executive functioning impairments His last OT assessment was six months ago. He scored below the 1st percentile on the visual processing section of the VMI. Although he scored in the average range on the motor coordination portion, he worked so slowly that he ran out of time to complete it. I don't know why not being able to complete it didn't lower his score. He was completely unable to participate in the class activity the OT observed because it required complex motor planning. They said he didn't qualify for OT services because he can type assignments instead of handwrite them.

He has no transition or leisure goals. He is supposed to get a transition plan started, but hasn't yet. They have said they will only do academic goals, not leisure goals.

 

[JSD24]

Seems strange that the school doesn't see the visual processing deficit as a disability where they use OT to address that.  The school needs to provide access.  If he can't participate in classroom activities, he should have accommodations and/or SDI so he can have access.  IDEA does say that schools need to work on leisure as well as academics.

[Jenna]

10 hours ago, HighSchoolParent said:

He scored below the 1st percentile on the visual processing section of the VMI. Although he scored in the average range on the motor coordination portion, he worked so slowly that he ran out of time to complete it. I don't know why not being able to complete it didn't lower his score. He was completely unable to participate in the class activity the OT observed because it required complex motor planning. They said he didn't qualify for OT services because he can type assignments instead of handwrite them.

Did he have higher scores in other OT areas if he scored in the <1% range on visual processing and the district isn't providing OT? What was the district's reasoning for not providing OT?

[HighSchoolParent]

6 hours ago, Jenna said:

Did he have higher scores in other OT areas if he scored in the <1% range on visual processing and the district isn't providing OT? What was the district's reasoning for not providing OT?

He scored higher on the motor coordination section of the VMI, BUT he had to sacrifice speed for accuracy. The shapes he drew, he drew accurately, but he went so slowly he didn't have time to do them all.

I submitted a private OT evaluation (the BOT) showing his fine motor coordination was 5 years below his age, but they dismissed it because it didn't include a class observation.

They said his OT needs are clinical and not educational, therefore they don't see a need for services. They also said it might be embarrassing for him to get services at his age (14).

It was such a fight to get him tested, then qualified, that I had to leave this particular issue unresolved.

 

[Jenna]

Did they give you a PWN stating that they don't feel there's an educational impact because your eval didn't include a class observation? Have you double checked your state's regs to see if there's any sort of a requirement that an IEE include a classroom observation? I'm not aware of any such requirement in my state. Unfortunately my state also only requires districts to "consider" a parent provided or district paid for IEE. Consideration means meeting to discuss the IEE, or, the district can provide a very thorough PWN explaining why they feel the IEE doesn't change the IEP.   Unfortunately, it is common for parents to have to explain the educational impact when districts say challenges are only medical issues. Not sure how far you want to appeal it with your procedural safeguards, but it sounds like considering your options (https://adayinourshoes.com/procedural-safeguards/) is the next step. 

[Jenna]

Adding the following clarification in case it can help others wondering about a student only receiving OT:
In a conference I attended today, a rep of my state's Dept. of Education said that the idea that a child can't receive only OT as a related service is a common, but incorrect myth in our state. If others have that question, I'd recommend double checking with your state's Dept. of Education to get clarification on your specific rules.