By Janine Calmes, PT, MS and Amy Collins, OTR, MOT
At TxSpot, we receive a lot of questions about dismissing a student from occupational therapy or physical therapy services in the school setting.
So…let's look at some of the questions and answers about this topic!
Is a reevaluation required to dismiss a student from occupational therapy or physical therapy services in Texas?
Texas school districts are responsible for developing their own policies that align with legal mandates. Many Texas school attorneys are currently advising districts to evaluate students prior to dismissing a service, such as occupational or physical therapy, and therefore, some districts have developed local policy that requires a re-evaluation before dismissal. Therapists should always follow the policies and procedures of the school districts in which they work.That being said, there is nothing in the Individuals with Disabilities Education Improvement Act (IDEA), the Texas Education Code, Texas occupational therapy or physical therapy licensure, or Texas Education Agency (TEA) guidance that stipulates a re-evaluation in order to discontinue a related service in the school setting. The decision to discontinue services is made by the ARD/IEP committee and must be based on current data regarding the unique educational needs of the student, but that data does not have to include a re-evaluation. Acceptable data could be a graphic representation of performance showing progress, work samples, parent information, outside evaluations, information from PLAAFP, etc. Some districts have created a form that prompts the provider to document the various sources of data used to make the recommendation to discontinue services. This helps make clear to all what data was utilized to make the decision. The form is often referred to as a Dismissal Summary; however, some caution that this might be viewed as predetermination of the outcome.
Texas physical therapists must be aware that a discharge summary is required by Texas Physical Therapy licensure rules before a client can be dismissed from service:
The PT must provide final documentation for discharge of a patient, including patient response to treatment at the time of discharge and any necessary follow-up plan. A PTA may participate in the discharge summary by providing subjective and objective patient information to the supervising physical therapist.
Texas Board of Physical Therapy Examiners RULES March 2022 §322.1.(e)(4)
Can a student be dismissed from services at an annual ARD/IEP meeting or only at a REED or 3-year reevaluation meeting?
The decision to dismiss services for a student can be made in any convened ARD/IEP meeting.
What are some considerations for dismissing a student from occupational therapy or physical therapy services at school?
When considering if a student is ready for dismissal from OT or PT services, it is your responsibility to understand the purpose of occupational therapy or physical therapy as a related service under IDEA, to collect and assess current data about a student's participation and performance, and to use your professional reasoning to determine if a student continues to NEED your service in order to benefit from his/her Individualized Education Program (IEP).Some guidelines for considering dismissal of services:
- Base your recommendation on current data from a variety of resources (parent, student, and teacher input, data collection, progress reports, observations). Make certain the data on which you are basing your recommendation are accurate.
- Determine if there are any areas where a student needs MORE than the other supports in his/her IEP or if the student is not anticipated to make continued progress without your service. If so, you may need to continue to provide support rather than dismissing the student.
- Some common reasons to consider discontinuing therapy services include:
- The student is able to participate in his/her educational program without additional support (there are no longer any goals/objectives that require support by OT / PT).
- The needed supports have been successfully integrated into the student's program so that ongoing involvement by OT / PT is no longer necessary.
- OT / PT has exhausted all supports/interventions with no positive impact.
- Seek to understand the concerns of parents or other IEP committee members, and address them with understanding and diplomacy.
- Be consistent with your professional reasoning - apply the same standards to each student.
- Remember that your job is to provide the IEP committee with your recommendation; the committee can always decide something different.
- Ask the IEP committee to document your recommendation in the paperwork, even if they choose not to follow it.
2022
