What to do when a student with needs is not eligible for services

Students may be found ineligible for special education (and for related services including OT) if they do not have a qualifying disability or, if they have a qualifying disability but are making effective progress in their educational program. In addition, some students may be found eligible for special education with a qualifying disability that is limiting their ability to make effective progress, but the team may not identify OT as a necessary service in the student’s Individualized Education Program (IEP).

It is always a difficult situation when the OT sees a student struggling day in and day out in school, or when a teacher is jumping through hoops and making multiple accommodations just to get a particular student through the day, and the OT knows that she can make a difference. And while we all do things on-the-fly as best we can to help out when we see a need, we also must be clear that occupational therapy services are not provided simply because the student can ‘benefit from’ those services. The public schools are responsible for providing all students with an education. Education is the primary service of the public schools and teachers are the primary service providers. OTs are related service providers. The public schools are not responsible for meeting all of the therapy needs of a student. Schools are mandated to provide therapy as a related service only if those services are necessary in order for a qualifying student with a disability to participate and progress in their educational program. This is an important mandate that all school OTs need to be able to clearly articulate to parents and other team members so that expectations are appropriate within the public school setting. 

Given these limitations of the role of occupational therapy in the public schools, it is important to take full advantage of the available opportunities to make a difference in the lives of students and teachers in need. The pre-referral/early intervening process and the evaluation process are two such opportunities.

Sometimes the occupational therapist’s only contact with the student is during the pre-referral/early intervening process. It is important that the therapist use this process as effectively as possible in the event that the student is not referred for evaluation or is not found eligible for special education and related services. Students can be supported through the pre-referral process when the OT and the general education teacher collaborate so that the general education teacher is able to better understand the student and is equipped with strategies to address the student’s needs. On the part of the OT, this typically involves observation of the student in the context where the difficulties are reported, collaboration with the teacher, and periodic check-ins to determine effectiveness and to determine different strategies as needed. Providing strategies for use in the general education setting that address the student, the activities and/or the environment such as altering the instructional approach, the classroom schedule, the task, the materials used, or the environment, can have a profound and positive impact on both the student and the teacher.  

The evaluation process is another opportunity for the OT to intervene on behalf of a student. A student may be referred for an occupational therapy evaluation, but in the case of an ineligible student, the OT may not be involved beyond the evaluation process. Keep in mind that the purpose of the evaluation is to assist the team in determining eligibility to special education services and, once eligibility is determined, to provide information to assist the team in formulating an appropriate IEP. The unique lens through which an OT looks at a student, the activities they perform and the context in which they perform them can provide valuable insight to a team and the power and impact of this should not be underestimated. The OT can reframe the student’s difficulties or behaviors for the team and provide information about the student’s strengths, areas of need and learning style, as well as provide strategies that will help the teacher and other involved adults to facilitate student participation and progress.

Public school occupational therapists can have a positive impact on the student and team by making full use of the opportunities inherent in the pre-referral and evaluation processes. This is true for any student, including those who end up receiving OT services, and it is especially true for those students who are not found eligible for further involvement from occupational therapy.