Exit Strategy from O.T. : Ask:
What would the child Not be getting if he/she did Not get O.T. ?
(ask this question too before providing O.T. in the first place)
Can this be supplied by the classroom staff?
Is the O.T. of a complexity and intricacy that meets the definition of “Skilled Therapy”?
Know that if therapists do not follow regulations (SBS School Based Services Federal/State funded) we can lose our license to practice.
Inform your administrator / principal of the rules we therapists operate under. We cannot keep student on schedule for just practice of skills that can be done by classroom staff.
(( Also , we know it is the taxpayer's money and it is the law).
Also: AOTA says: skilled only therapy. (the before mentioned paragraph is the single most helpful one which most stops parents and principals from insisting student continue maintenance or unskilled therapy, practice, plateaued, etc.). Do they want us to be illegal or lose our license?
Convince team: Most activities of the basic levels: (ROM, ADL’s, SI, Sensory Diet, Handwriting program, splint application, etc) can be taught to the classroom staff to carry out, therapists do not have to do it for years of therapy. Also: make sure you provide classroom with tracking form to be sent home weekly or monthly to show the parent it is happening in the classroom daily/weekly? Parents feel much more comfortable discontinuing direct O.T. if they know the classroom staff is considered responsible on a daily / weekly basis on carrying through skills student has learned and just needs to practice.
Inform the parent, teacher, and principal: The student (should he/she regress) can always be reassessed and O.T. services reinstituted should this be appropriate). Also, the therapist is available to contact with questions and concerns.
Does parent, teacher, and administrator understand:
It is my belief that: The IEP Team consensus decides who does/does not get therapy,and for how long (not the parent threatening a hearing, or the administrator who wants to avoid one).
Therapists cannot bill SBS for unskilled therapy. Regular ADL's (that don't require special adapted techniques/ equipment , and even some that do, and regular ADL's do not require continued intervention directly by the O.T. after the skilled portions of therapy are completed.
Note: General beneficial informative O.T. websites:
otexchange.com (register, information, documents, school)
Look at documents including those on exit strategies or discontinuing therapy
Other helpful sites for general O.T. information:
Who can add to above Exit strategy criteria
(to convince parents their student can be served now by the classroom)?
Who can add to valuable websites?
Donna, the two links you provided are not working. Wonder if you can repost?
Also, nice start on the questions for exit strategies. I will look at otexchange too.
I have a consultative model rather than a direct service model. I see the kids long enough to keep in touch with their skills, 60 min/mo. But, I don't contribute to the data collection for determining progress. I provide anecdotal information that helps the teacher and team decide whether this information is useful in setting goals and determining programs and supports.
I generally ask the same questions regarding consultation-is there someone else already providing the service, knowing that consultation is a process, not a meeting. With each annual conference report time I provide recommendations for goals whether it is fine motor, functional, sensory, or behavior/participation.
most excellent ot resource website I have seen