When I began my career as a school-based Occupational Therapist (OT) eighteen years ago, I believed I could do it all.
With the Certified Occupational Therapy Assistants (COTAs,) our enthusiasm, and our magic wands, we could treat every student, climb over every wall, and break down all barriers to participation. That was the fun part!
The not-so-fun part was the avalanche of paperwork burying us along the way. During marathon OT sessions, we provided a paper trail for every step we helped students take, evidence we were working hard with them to reach their OT goals.
Documentation, weekly notes, ACCESS billing, parent communications, individualized education program (IEP) development, classroom programs, progress monitoring goals… and more goals… and more goals. All necessary. All part of the job.
While my team and I eagerly wanted to share stories about the progress our students were making on their journeys, harried teachers who were stressed and weighed down with their own mountain of forms just wanted our input about OT goals and objectives on the IEP. Despite their positive outcomes during occupational therapy, students weren’t replicating their stellar progress in the teachers’ classrooms.
This disconnect between outcomes realized in OT and in the class setting became another obstacle to overcome. I had to find a way to bridge this gap.
It didn’t matter how wonderfully the student worked for us in OT. If he or she could not succeed in the classroom, OT would continue indefinitely. The marathon would turn into a race on a hamster wheel.
I had to get us off that wheel.
Serve Students Best by Keeping School-Based OT Goals in Perspective
Ultimately, the goals on an IEP are supposed to be about the student.
But forgetting to keep goals properly focused on students becomes the norm when parents and advocates want goals specifically identified by each discipline written into the IEP.
This lack of focus leaves us with a Rubik’s Cube IEP—a jumble of different parts and distinct boundaries, a “this is mine and this is yours” approach—rather than a seamless individualized education plan supporting the student’s ability to engage and learn.
In the school setting, occupational therapy is supportive. Education is the primary service. Keeping this priority clearly in mind, we collaborated with the team to create student goals, not OT goals.
Initially, we met with resistance. The COTAs and I had to break through the “this is how we’ve always done it” mentality.
It was a tough uphill climb, but eventually we made it over the hump to show the IEP team successful and relevant student outcomes where we supported the teacher, the student, and the IEP goals instead of creating separate OT goals on the IEP.
The federal regulations make it clear “IDEA does NOT require goals to be written for each specific discipline or to have outcomes and measurements on a specific assessment tool.” You can find this provision on page 46662 of the Federal Register (Vol. 71, No. 156), which presents the U.S. Department of Education’s 2006 final rule on Assistance to States for Education of Children with Disabilities and Preschool Grants for Children with Disabilities.
But while the law does not require separate discipline goals, it also does not prohibit such goals. If the school team decides the OT will be solely responsible for a particular objective, that is what it will write into an IEP.
We have learned to avoid these tripping stones by defining our role as a related service provider. When the teacher asks us, “Where are your OT goals?,” we identify the student goals on the IEP we will help the student achieve. Our goals are their goals. We are going to cross that finish line together with the student as a team.
Thanks to Liz for reminding us of how important it is for IEP goals to be the child’s goals, not discipline-specific goals! If you’d like to find out how you can join PTS’ team as an occupational therapist, please click here to contact us.