Occupational Therapy
anD Physical Therapy
A Resource and Planning Guide
Wisconsin Department of Public Instruction
, Occupational Therapy and
Physical Therapy: A Resource and
Planning Guide
Second Edition
Developed by
Patricia Bober, MS, OT
Occupational Therapy Consultant
Wisconsin Department of Public Instruction
Sandra Corbett, PT
Physical Therapy Consultant
Wisconsin Department of Public Instruction
Wisconsin Department of Public Instruction
Tony Evers, PhD, State Superintendent
Madison, Wisconsin
, This publication is available from:
Wisconsin Department of Public Instruction
125 South Webster Street
Madison, WI 53703
608/266-2188
http://dpi.wi.gov/sped/tm-specedtopics.html
Bulletin No. 1106
© May 2011 Wisconsin Department of Public Instruction
This publication was made possible by funding from CFDA #84.027. Its content may be reprinted in whole or in
part, with credit to Wisconsin Department of Public Instruction acknowledged. However, reproduction of this
publication in whole or in part for resale must be authorized by the Wisconsin Department of Public Instruction.
ISBN 978-1-57337-148-3
The Wisconsin Department of Public Instruction does not discriminate on the basis of sex, race,
color, religion, creed, age, national origin, ancestry, pregnancy, marital status
or parental status, sexual orientation, or disability.
Printed on Recycled Paper
,Foreword
ccupational therapists and physical therapists have provided services to
O children in Wisconsin’s schools for almost 40 years. Their role is to help
children develop skills and perform tasks that most people take for
granted in their own lives.
The Department of Public Instruction created this book to explain how
occupational therapists (OTs) and physical therapists (PTs) collaborate with
educators, administrators, and parents to support the mission of education in the
environment of the schools. This book answers questions about who OTs and
PTs are, what their purpose is in schools, and how, working with educators and
parents, they help Wisconsin’s children acquire the skills and knowledge they
need to participate alongside other children in school and, eventually, assume
positive adult roles in the community.
This publication will help school staff and parents better understand the key
roles OTs and PTs play in the lives of children who need their services to benefit
from their education. Their work supports our shared goal that every child will
graduate with the knowledge and skills needed to be successful in the workforce
and/or higher education. I believe this publication will support the work of all of
us who believe education is the most important element to ensure a successful
future for our children and our nation.
Tony Evers
State Superintendent
Foreword iii
,
,Acknowledgments
The authors wish to thank all the occupational therapists, physical therapists, occupational therapy
assistants, physical therapist assistants, and special educators in Wisconsin who asked the questions that
led to the development of this resource and planning guide. The following people provided help and
support in many ways: by writing and reviewing drafts; by sharing materials; and by providing feedback
and encouragement.
Kris Barnekow, Ph.D., OTR Dan Kutschera, PT
University of Illinois Neenah School District
Chicago, Illinois Neenah, Wisconsin
Valerie D. Clevenger, PT, MS, PCS Marcia Obukowicz, OT
Waunakee School District CESA 9
Waunakee, Wisconsin Tomahawk, Wisconsin
Judy Dewane, PT, MHS, NCS Tracy Prill, OTA
University of Wisconsin Edgerton School District
Madison, Wisconsin Edgerton, Wisconsin
Lori Dominiczak, PT, MS Lisa Pugh
Dominiczak Therapy Associates, LLC Parent
Brown Deer, Wisconsin Madison, Wisconsin
Marie Dorie Judy Schabert, OTR
Director of Special Ed/Pupil Services Salucare Rehabilitation Service
CESA 2 LaCrosse, Wisconsin
Milton, Wisconsin
Kathy Tomczyk, PTA, MS
Mardi Freeman Milwaukee Area Technical College
Director of Special Education and Pupil Services Milwaukee, Wisconsin
Hamilton School District
Sussex, Wisconsin Patty Weynand, PT
Madison Metropolitan School District
Kerry Gloss, OTR Madison, Wisconsin
Green Bay Public Schools
Green Bay, Wisconsin Janesville School District
Janesville, Wisconsin
Gerry Heuer, BS, COTA
DeForest School District Waukesha School District
DeForest, Wisconsin Waukesha, Wisconsin
Acknowledgements v
, Special thanks to:
Division for Learning Support: Equity and Advocacy
Carolyn Stanford Taylor, Assistant State Superintendent
Stephanie Petska, Director, Special Education Team
State Superintendent's Office
Meri Annin, Education Information Services
Kari Gensler Santistevan, Education Information Services
Margaret T. Dwyer, Editor
Copyrighted Materials
Every effort has been made to ascertain proper ownership on copyrighted materials and to obtain
permission for this use. Any omission is unintentional.
vi Table of Contents
,Table of Contents
Foreword................................................................................................................................................... iii
Acknowledgements................................................................................................................................... v
Introduction............................................................................................................................................... 1
Chapter 1 Occupational Therapy and Physical Therapy in Wisconsin Schools ...................... 3
Chapter 2 Federal Regulations and State Rules .......................................................................... 5
Individuals with Disabilities Education Act (IDEA) ..................................................... 5
Section 504 of the Rehabilitation Act ........................................................................... 7
Subchapter V, Chapter 115, Wisconsin Statutes ............................................................ 9
Chapter 448, Wisconsin Statutes .................................................................................... 14
Licensure Requirements ................................................................................................. 16
Space and Facilities ........................................................................................................ 20
Laws Protecting Confidentiality .................................................................................... 20
Chapter 3 The IEP Team Process in School ................................................................................ 25
Referral ........................................................................................................................... 25
Initial Evaluation ............................................................................................................ 25
Eligibility for Occupational Therapy and Physical Therapy .......................................... 29
Least Restrictive Environment ....................................................................................... 42
Re-evaluation.................................................................................................................. 44
Chapter 4 School-Based Occupational Therapy.......................................................................... 49
Conceptual Frameworks ................................................................................................. 50
Occupational Therapy Initial Evaluation........................................................................ 55
Other School Occupational Therapy Evaluations .......................................................... 67
Intervention..................................................................................................................... 69
Record Keeping .............................................................................................................. 88
Ethics .............................................................................................................................. 89
Chapter 5 School-Based Physical Therapy .................................................................................. 95
Competencies for School-Based PTs ............................................................................. 95
Conceptual Frameworks ................................................................................................. 95
Medical Referral and Medical Information .................................................................... 100
Initial Evaluation and Examination ................................................................................ 102
Physical Therapy Intervention Plan................................................................................ 106
Interventions ................................................................................................................... 106
Evidence-based Practice and Critical Inquiry ................................................................ 109
Progress Reports and Reexamination ............................................................................. 113
Discontinuation............................................................................................................... 113
Documentation ............................................................................................................... 117
Communication .............................................................................................................. 118
Fitness and Health .......................................................................................................... 118
Privacy ............................................................................................................................ 118
Ethics .............................................................................................................................. 120
Occupational Therapy and Physical therapy: A Resource and Planning Guide vii
, Chapter 6 Supervision of Assistants and Other Personnel ......................................................... 125
Occupational Therapy Assistants and Physical Therapist Assistants ............................. 125
Non-licensed Personnel and Occupational Therapy ....................................................... 131
Non-licensed Personnel and Physical Therapy ............................................................... 132
Clinical Affiliations and Training Opportunities ............................................................ 134
Chapter 7 Collaborative Service Provision................................................................................... 139
Collaboration in School for Children with Disabilities .................................................. 139
Collaboration in School for Children without Disabilities ............................................. 154
Collaboration with Providers Outside of School Environments ..................................... 159
Collaboration with Parents.............................................................................................. 160
Chapter 8 Administration of Occupational Therapy and Physical Therapy in School............ 167
Determining Service Need .............................................................................................. 167
Providing Staff ................................................................................................................ 172
The Interview .................................................................................................................. 181
Orientation ...................................................................................................................... 182
Assuring Quality ............................................................................................................. 182
Evaluating Staff Performance ......................................................................................... 184
Evaluating Outcomes ...................................................................................................... 190
Equipment ....................................................................................................................... 191
Facilities .......................................................................................................................... 191
Changes in Staff .............................................................................................................. 192
Reimbursement ............................................................................................................... 192
Records ........................................................................................................................... 194
Liability........................................................................................................................... 197
Chapter 9 Questions and Answers ................................................................................................ 201
IEP Team ........................................................................................................................ 201
IEP .................................................................................................................................. 203
Caseload .......................................................................................................................... 206
Documentation ................................................................................................................ 206
Other Practice Issues ....................................................................................................... 207
Recruitment..................................................................................................................... 209
Licensing Issues .............................................................................................................. 213
Chapter 10 Appendix A: Organizations ............................................................................................ 213
Appendix B: Sample Treatment Plans ............................................................................ 221
Appendix C: Pediatric Physical Therapy Assessment Tools .......................................... 227
Appendix D: Codes of Ethics for Occupational Therapy and Physical Therapy ............ 233
Appendix E: Equipment Forms ...................................................................................... 239
Appendix F: Sample Position Descriptions .................................................................... 247
viii Table of Contents
, Introduction
Occupational Therapy and Physical Therapy: A
Resource and Planning Guide, Second Edition
This book, Occupational Therapy and Physical Therapy: A Resource and
Planning Guide, Second Edition, defines and explains the meaning and purpose
of these interrelated, but distinct, types of therapy and offers readers the This book explains the
opportunity to understand the roles of therapists as part of the school work and roles of
environment. Readers may wish to read the entire book as a w hole, or may occupational therapists
choose to focus on t hose chapters or sections most related to their work. Every and physical therapists
chapter is understandable on its own, but a complete reading will result in more in Wisconsin's schools.
comprehensive and effective understanding for the reader. A revision of the first
edition published in 1996, the book is thoroughly updated to reflect the changing
practice of school-based therapies.
Chapter 1 provides basic historical information to readers about occupational
therapy and physical therapy with children in schools. The chapter introduces a
collaborative model of service that subsequent chapters describe in greater depth.
Chapter 2 offers succinct descriptions and interpretations of the state and
federal laws that apply to occupational therapy and physical therapy in the
schools. As part of this, the chapter covers recent changes in licensure and
certification issues that all occupational therapists (OTs) and physical therapists
(PTs) should know.
In chapter 3, readers gain access to the two initial steps of therapy: eligibility
and process. Process involves recognizing the need to evaluate a child for
occupational therapy or physical therapy, planning a program that includes either
therapy, and delivering services that maximize outcomes most useful to the child
in school. The third chapter also features many tools to help educators and
therapists understand their roles in the process. Sample checklists will assist
teachers in describing the performance of a child who needs strategies or
accommodations. In addition, these tools allow teachers to record previous
efforts made in response to the child's needs. A sample Individualized Education
Program resulting from a team evaluation contains a variety of helpful, detailed
examples of goals and objectives that occupational therapy or physical therapy
supports.
Chapter 4 focuses specifically on oc cupational therapy and the role of the
OTs in schools. Both the text and figures of this chapter clarify the purpose of
occupational therapy: the support of health and participation in life through
engagement in occupation. The authors present and use conceptual frameworks
to discuss the critical elements of occupational therapy practice. The chapter ends
with a brief discussion of the ethics of the profession.
Occupational Therapy and Physical Therapy: A Resource and Planning Guide 1
anD Physical Therapy
A Resource and Planning Guide
Wisconsin Department of Public Instruction
, Occupational Therapy and
Physical Therapy: A Resource and
Planning Guide
Second Edition
Developed by
Patricia Bober, MS, OT
Occupational Therapy Consultant
Wisconsin Department of Public Instruction
Sandra Corbett, PT
Physical Therapy Consultant
Wisconsin Department of Public Instruction
Wisconsin Department of Public Instruction
Tony Evers, PhD, State Superintendent
Madison, Wisconsin
, This publication is available from:
Wisconsin Department of Public Instruction
125 South Webster Street
Madison, WI 53703
608/266-2188
http://dpi.wi.gov/sped/tm-specedtopics.html
Bulletin No. 1106
© May 2011 Wisconsin Department of Public Instruction
This publication was made possible by funding from CFDA #84.027. Its content may be reprinted in whole or in
part, with credit to Wisconsin Department of Public Instruction acknowledged. However, reproduction of this
publication in whole or in part for resale must be authorized by the Wisconsin Department of Public Instruction.
ISBN 978-1-57337-148-3
The Wisconsin Department of Public Instruction does not discriminate on the basis of sex, race,
color, religion, creed, age, national origin, ancestry, pregnancy, marital status
or parental status, sexual orientation, or disability.
Printed on Recycled Paper
,Foreword
ccupational therapists and physical therapists have provided services to
O children in Wisconsin’s schools for almost 40 years. Their role is to help
children develop skills and perform tasks that most people take for
granted in their own lives.
The Department of Public Instruction created this book to explain how
occupational therapists (OTs) and physical therapists (PTs) collaborate with
educators, administrators, and parents to support the mission of education in the
environment of the schools. This book answers questions about who OTs and
PTs are, what their purpose is in schools, and how, working with educators and
parents, they help Wisconsin’s children acquire the skills and knowledge they
need to participate alongside other children in school and, eventually, assume
positive adult roles in the community.
This publication will help school staff and parents better understand the key
roles OTs and PTs play in the lives of children who need their services to benefit
from their education. Their work supports our shared goal that every child will
graduate with the knowledge and skills needed to be successful in the workforce
and/or higher education. I believe this publication will support the work of all of
us who believe education is the most important element to ensure a successful
future for our children and our nation.
Tony Evers
State Superintendent
Foreword iii
,
,Acknowledgments
The authors wish to thank all the occupational therapists, physical therapists, occupational therapy
assistants, physical therapist assistants, and special educators in Wisconsin who asked the questions that
led to the development of this resource and planning guide. The following people provided help and
support in many ways: by writing and reviewing drafts; by sharing materials; and by providing feedback
and encouragement.
Kris Barnekow, Ph.D., OTR Dan Kutschera, PT
University of Illinois Neenah School District
Chicago, Illinois Neenah, Wisconsin
Valerie D. Clevenger, PT, MS, PCS Marcia Obukowicz, OT
Waunakee School District CESA 9
Waunakee, Wisconsin Tomahawk, Wisconsin
Judy Dewane, PT, MHS, NCS Tracy Prill, OTA
University of Wisconsin Edgerton School District
Madison, Wisconsin Edgerton, Wisconsin
Lori Dominiczak, PT, MS Lisa Pugh
Dominiczak Therapy Associates, LLC Parent
Brown Deer, Wisconsin Madison, Wisconsin
Marie Dorie Judy Schabert, OTR
Director of Special Ed/Pupil Services Salucare Rehabilitation Service
CESA 2 LaCrosse, Wisconsin
Milton, Wisconsin
Kathy Tomczyk, PTA, MS
Mardi Freeman Milwaukee Area Technical College
Director of Special Education and Pupil Services Milwaukee, Wisconsin
Hamilton School District
Sussex, Wisconsin Patty Weynand, PT
Madison Metropolitan School District
Kerry Gloss, OTR Madison, Wisconsin
Green Bay Public Schools
Green Bay, Wisconsin Janesville School District
Janesville, Wisconsin
Gerry Heuer, BS, COTA
DeForest School District Waukesha School District
DeForest, Wisconsin Waukesha, Wisconsin
Acknowledgements v
, Special thanks to:
Division for Learning Support: Equity and Advocacy
Carolyn Stanford Taylor, Assistant State Superintendent
Stephanie Petska, Director, Special Education Team
State Superintendent's Office
Meri Annin, Education Information Services
Kari Gensler Santistevan, Education Information Services
Margaret T. Dwyer, Editor
Copyrighted Materials
Every effort has been made to ascertain proper ownership on copyrighted materials and to obtain
permission for this use. Any omission is unintentional.
vi Table of Contents
,Table of Contents
Foreword................................................................................................................................................... iii
Acknowledgements................................................................................................................................... v
Introduction............................................................................................................................................... 1
Chapter 1 Occupational Therapy and Physical Therapy in Wisconsin Schools ...................... 3
Chapter 2 Federal Regulations and State Rules .......................................................................... 5
Individuals with Disabilities Education Act (IDEA) ..................................................... 5
Section 504 of the Rehabilitation Act ........................................................................... 7
Subchapter V, Chapter 115, Wisconsin Statutes ............................................................ 9
Chapter 448, Wisconsin Statutes .................................................................................... 14
Licensure Requirements ................................................................................................. 16
Space and Facilities ........................................................................................................ 20
Laws Protecting Confidentiality .................................................................................... 20
Chapter 3 The IEP Team Process in School ................................................................................ 25
Referral ........................................................................................................................... 25
Initial Evaluation ............................................................................................................ 25
Eligibility for Occupational Therapy and Physical Therapy .......................................... 29
Least Restrictive Environment ....................................................................................... 42
Re-evaluation.................................................................................................................. 44
Chapter 4 School-Based Occupational Therapy.......................................................................... 49
Conceptual Frameworks ................................................................................................. 50
Occupational Therapy Initial Evaluation........................................................................ 55
Other School Occupational Therapy Evaluations .......................................................... 67
Intervention..................................................................................................................... 69
Record Keeping .............................................................................................................. 88
Ethics .............................................................................................................................. 89
Chapter 5 School-Based Physical Therapy .................................................................................. 95
Competencies for School-Based PTs ............................................................................. 95
Conceptual Frameworks ................................................................................................. 95
Medical Referral and Medical Information .................................................................... 100
Initial Evaluation and Examination ................................................................................ 102
Physical Therapy Intervention Plan................................................................................ 106
Interventions ................................................................................................................... 106
Evidence-based Practice and Critical Inquiry ................................................................ 109
Progress Reports and Reexamination ............................................................................. 113
Discontinuation............................................................................................................... 113
Documentation ............................................................................................................... 117
Communication .............................................................................................................. 118
Fitness and Health .......................................................................................................... 118
Privacy ............................................................................................................................ 118
Ethics .............................................................................................................................. 120
Occupational Therapy and Physical therapy: A Resource and Planning Guide vii
, Chapter 6 Supervision of Assistants and Other Personnel ......................................................... 125
Occupational Therapy Assistants and Physical Therapist Assistants ............................. 125
Non-licensed Personnel and Occupational Therapy ....................................................... 131
Non-licensed Personnel and Physical Therapy ............................................................... 132
Clinical Affiliations and Training Opportunities ............................................................ 134
Chapter 7 Collaborative Service Provision................................................................................... 139
Collaboration in School for Children with Disabilities .................................................. 139
Collaboration in School for Children without Disabilities ............................................. 154
Collaboration with Providers Outside of School Environments ..................................... 159
Collaboration with Parents.............................................................................................. 160
Chapter 8 Administration of Occupational Therapy and Physical Therapy in School............ 167
Determining Service Need .............................................................................................. 167
Providing Staff ................................................................................................................ 172
The Interview .................................................................................................................. 181
Orientation ...................................................................................................................... 182
Assuring Quality ............................................................................................................. 182
Evaluating Staff Performance ......................................................................................... 184
Evaluating Outcomes ...................................................................................................... 190
Equipment ....................................................................................................................... 191
Facilities .......................................................................................................................... 191
Changes in Staff .............................................................................................................. 192
Reimbursement ............................................................................................................... 192
Records ........................................................................................................................... 194
Liability........................................................................................................................... 197
Chapter 9 Questions and Answers ................................................................................................ 201
IEP Team ........................................................................................................................ 201
IEP .................................................................................................................................. 203
Caseload .......................................................................................................................... 206
Documentation ................................................................................................................ 206
Other Practice Issues ....................................................................................................... 207
Recruitment..................................................................................................................... 209
Licensing Issues .............................................................................................................. 213
Chapter 10 Appendix A: Organizations ............................................................................................ 213
Appendix B: Sample Treatment Plans ............................................................................ 221
Appendix C: Pediatric Physical Therapy Assessment Tools .......................................... 227
Appendix D: Codes of Ethics for Occupational Therapy and Physical Therapy ............ 233
Appendix E: Equipment Forms ...................................................................................... 239
Appendix F: Sample Position Descriptions .................................................................... 247
viii Table of Contents
, Introduction
Occupational Therapy and Physical Therapy: A
Resource and Planning Guide, Second Edition
This book, Occupational Therapy and Physical Therapy: A Resource and
Planning Guide, Second Edition, defines and explains the meaning and purpose
of these interrelated, but distinct, types of therapy and offers readers the This book explains the
opportunity to understand the roles of therapists as part of the school work and roles of
environment. Readers may wish to read the entire book as a w hole, or may occupational therapists
choose to focus on t hose chapters or sections most related to their work. Every and physical therapists
chapter is understandable on its own, but a complete reading will result in more in Wisconsin's schools.
comprehensive and effective understanding for the reader. A revision of the first
edition published in 1996, the book is thoroughly updated to reflect the changing
practice of school-based therapies.
Chapter 1 provides basic historical information to readers about occupational
therapy and physical therapy with children in schools. The chapter introduces a
collaborative model of service that subsequent chapters describe in greater depth.
Chapter 2 offers succinct descriptions and interpretations of the state and
federal laws that apply to occupational therapy and physical therapy in the
schools. As part of this, the chapter covers recent changes in licensure and
certification issues that all occupational therapists (OTs) and physical therapists
(PTs) should know.
In chapter 3, readers gain access to the two initial steps of therapy: eligibility
and process. Process involves recognizing the need to evaluate a child for
occupational therapy or physical therapy, planning a program that includes either
therapy, and delivering services that maximize outcomes most useful to the child
in school. The third chapter also features many tools to help educators and
therapists understand their roles in the process. Sample checklists will assist
teachers in describing the performance of a child who needs strategies or
accommodations. In addition, these tools allow teachers to record previous
efforts made in response to the child's needs. A sample Individualized Education
Program resulting from a team evaluation contains a variety of helpful, detailed
examples of goals and objectives that occupational therapy or physical therapy
supports.
Chapter 4 focuses specifically on oc cupational therapy and the role of the
OTs in schools. Both the text and figures of this chapter clarify the purpose of
occupational therapy: the support of health and participation in life through
engagement in occupation. The authors present and use conceptual frameworks
to discuss the critical elements of occupational therapy practice. The chapter ends
with a brief discussion of the ethics of the profession.
Occupational Therapy and Physical Therapy: A Resource and Planning Guide 1
