An Independent Educational Evaluation (IEE) is an evaluation conducted by a person who is not part of the school district. Once a request for an IEE is made, the district must either respond by providing the district’s criteria for IEEs and let the parent know where they can obtain one or the school district must file a due process hearing. In most cases, districts choose to grant the IEE in an effort to work together with the parent and reach consensus. You can read more about the school district’s obligations HERE.

Once the IEE is completed, the ARD committee must consider the evaluation when determining a student’s needs; however, it is not required that they adopt the recommendations in the IEE report. When the IEE addresses occupational therapy (OT) or physical therapy (PT), the school district will often want the expertise of their school OT or PT to help the ARD/IEP committee understand the report. The school-based therapist will want to carefully review the IEE and make note of information that could assist the ARD/IEP committee in making decisions. It is important to remain objective in this process, and not to criticize or agree with it. Remember that, in most cases, the district’s decision to grant an IEE is not a reflection on you as a provider or their trust in you.

Here are some things to consider:

• Did the evaluator observe the student in the school setting? Children often perform differently in different environments; factors such as amount of structure, the child to adult ratio, noise level, and physical barriers such as curbs and heavy doors can all affect how successful the child is.

• Did the evaluator elicit information from personnel in the school who work with the student?  Teachers, paraprofessionals, and other providers who work with the student can have important information about the typical performance and participation of the student.

• Did the evaluation focus on performance and participation?  If standardized testing was done, did the results help identify the student’s ability to perform needed tasks at school and participate in school activities, or did they identify the student’s motor or sensory deficits in isolation? Do the recommendations address clinical or medical needs instead of educational needs? Make sure you are familiar with any testing that was done as part of the IEE so that you can explain its purpose and scoring to the ARD committee. Likewise, you may need to explain any unfamiliar terms.

• Are the student’s needs already being met in other ways? There is often more than one way to provide needed support to a student.  Consider whether the school is meeting the needs identified in different ways than are recommended in the IEE. Does your data show the student is making progress on his/her goals? If so, be ready to help the ARD committee understand that the current supports, including time and frequency of services, are adequate to meet the student’s needs.

In the educational setting in Texas, dysgraphia is a specific learning disability (SLD) for which identification and intervention are guided by the Dyslexia Handbook (2024). When a student is suspected of having dysgraphia, the school must follow procedures consistent with the Individuals with Disabilities Education Act (IDEA, 2004) for conducting a Full and Individualized Initial Evaluation (FIIE). The FIIE must determine whether the student has a disability and needs specially designed instruction. This is often referred to as eligibility. If a student is determined to be eligible for Special Education, the FIIE data will also provide information that will be used by the Admission, Review, and Dismissal (ARD) committee to determine the content of the student’s Individualized Education Program (IEP).

A multidisciplinary team is a group of professionals responsible for evaluating a student in all areas of suspected disability. Members of this team contribute their unique skill sets to the evaluation process. “The members work together to gather, analyze, and interpret evaluation data so that no one member makes unilateral decisions” (Dyslexia Handbook, 2024, p.31). Of particular note to occupational therapists is the recent addition of this statement, “When dysgraphia is suspected, an occupational therapist may be a necessary member of the team” (Dyslexia Handbook, 2024, p.31). Since the revised Dyslexia Handbook will be in effect for the beginning of the 2024-2025 school year, occupational therapists may be asked even more frequently to participate in these evaluations.  

There are many areas occupational therapists can contribute to an FIIE if dysgraphia is suspected. An occupational therapist can evaluate student factors such as posture, stability, hand dominance, graphomotor skills, visual perception, and sensory processing and can also provide information about the student’s environment that may affect their writing. One of the unique skills an occupational therapist can contribute is the ability to task analyze the writing process to provide insight into what may be interfering with legibility and fluency.

There is no one measure that can determine whether a student has dysgraphia; however, occupational therapists might administer certain assessment tools to contribute to the multidisciplinary team’s data. Several assessment tools have been developed that address both legibility and fluency of writing, including the Minnesota Handwriting Assessment, Detailed Assessment of Speed of Handwriting (DASH), The Print Tool, and the DeCoste Writing Protocol.

Students who meet the criteria for a specific learning disability due to the identification of dysgraphia and who need specially designed instruction are eligible for special education and related services under IDEA. If a student is identified as having dysgraphia but does not meet the criteria for eligibility under IDEA, the student may be eligible for accommodations and services under Section 504 of the Rehabilitation Act of 1973. 

Yes, occupational therapists and physical therapists can and do evaluate students who are not in Special Education. 

EVALUATING AS PART OF AN FIIE  

One way is as part of the collaborative team conducting the Full Individual and Initial Evaluation (FIIE). In this case, the OT or PT evaluation contributes to the comprehensive data-gathering from which the ARD committee makes decisions about the student’s eligibility for special education.   

Because school districts have an obligation to evaluate in all areas of suspected disability, OTs and PTs may also be asked to make recommendations during the FIIE as to the educational need for OT or PT services. The most common reasons OT or PT may be included in the FIIE are that the student received the therapy in the past, there are concerns about the student that fall into the domains that OT of PT address such as motor or sensory processing, or the parent specifically requests an OT or PT evaluation. Making sound recommendations in this situation can be tricky. 

This is because school-based OT and PT evaluations are context-dependent, meaning contextual factors must be considered. When doing an evaluation for a student who is already receiving Special Education, the OT or PT collects data on a variety of contextual factors such as the student’s placement, curriculum, goals, supports in place, progress on established goals, and other factors in the student’s environment that may help support or hinder the student’s participation. These considerations help determine whether the student needs the additional support of OT or PT to benefit from his special education program.

However, when evaluating during the FIIE process, many of these contextual factors have not yet been determined. In this case, you will need to gather as much data as possible to help determine whether the student is likely to need your support. Interview the teacher, parent, previous providers (with the appropriate signed release of information), and the diagnostician. Conduct your evaluation by viewing the student through the lens of how this child might function in the educational environment and do your best to determine whether he is likely to need your support. Make your recommendations and record them in your evaluation report. Then, listen carefully during the ARD meeting. If the eligibility, placement, or supports are different than you anticipated and this results in the student requiring a different level of support from you, change your recommendations accordingly. Discuss this with the ARD committee and ask that the change of recommendation and the reason for the change be recorded in the deliberations.

EVALUATING AS PART OF THE 504 COMMITTEE

School-based occupational therapists and physical therapists also play a role in evaluating students for needed accommodations and services under Section 504 of the Rehabilitation Act of 1973. Section 504 prohibits discrimination against individuals with disabilities in programs receiving federal financial assistance. Therapists assess students’ functional limitations related to their disabilities and recommend accommodations, supports, and/or services to ensure equal access to educational opportunities. These accommodations may include modifications to the physical environment, assistive technology, specialized equipment, or other reasonable adjustments to facilitate the student’s participation in school activities.  The evaluation process under Section 504 is focused on identifying barriers to learning and implementing appropriate interventions to address those barriers, ensuring that students with disabilities have equal access to education. Decisions about a student’s 504 plan are made by a 504 Committee.

Occupational therapists and physical therapists can and do evaluate students as part of the collaborative team conducting the FIE. In this case, their evaluation contributes to the comprehensive data-gathering from which the ARD/IEP team makes decisions about the student’s eligibility for special education.

Occupational therapists or physical therapists may also be asked to evaluate a student who has already been identified under IDEA as a student eligible for special education. In this case, the evaluation is to assist the ARD/IEP team with determining whether there is an educational need for occupational therapy or physical therapy services to be added to their IEP in support of the student’s goals and objectives.

Occupational therapy or physical therapy evaluations under IDEA can serve either purpose separately or both at once. 

You will certainly be gathering data for your reevaluation any time you are with the student, but as you get close to the due date for the reevaluation, I don’t know of any reason you can’t use the intervention sessions to do some formal testing if it is needed. Be sure to continue interacting with the campus personnel so that you also know if there are issues you need to address (in other words, don’t be so singularly focused on data-gathering that you aren’t aware of and responsive to instructional personnel). The Texas Education Agency has also provided guidance that students are not to be “overserved”, so be careful not to spend all of the student’s intervention time evaluating and then have no time left to meet the student’s current needs.

The Texas Board of Occupational Therapy Examiners (TBOTE) Rule §362.1 (28) defining the Occupational Therapy Plan of Care specifies that “A written statement of the planned course of Occupational Therapy intervention . . . must include goals, objectives and/or strategies, recommended frequency and duration . . .”  TBOTE Rules do not say that the required elements must be on the evaluation report itself, but it is clear that they need to be written. 

The Texas Board of Physical Therapy Examiners (TBPTE) Rule §322.1 (c), in describing the Physical Therapy plan of care development and implementation, states that “(1) The PT must develop a written plan of care, based on his evaluation, for each patient” and “(3) The plan of care must be reviewed and updated as necessary following a reevaluation of the patient’s condition.” 

TBPTE Rule §346.1 regarding practice in Education Settings, gives the following guidance:

(a) In the educational setting, the physical therapist conducts appropriate screenings, evaluations, and assessments to determine needed services to fulfill educational goals. When a student is determined by the physical therapist to be eligible for physical therapy as a related service under Part B of the Individuals with Disabilities Education Act (IDEA), 20 USC § 1414, or Section 504 of the Americans with Disabilities Act, as Amended, the physical therapist provides written recommendations to the Admissions Review and Dismissal Committee or the Section 504 Committee as to the amount of specific services needed by the student (i.e., direct and/or indirect services as well as the frequency, duration, and location of services).

Thus, the physical therapy rules state that the plan of care must be written based on the evaluation, but do not specify that the plan of care must be included in the evaluation report itself; the guidelines for the educational setting simply state that written recommendations will be provided to the Admissions Review and Dismissal committee.

Although including the items that constitute the Plan of Care are usually in the evaluation report, one ISD in the Houston area has chosen to write their OT and/or PT recommendations on a separate document that is brought to the IEP meeting along with the written report. The document is called “OT and/or PT Plan of Care” and includes all the required elements. In some cases, the PT or OT may modify his/her recommendations as a result of the information shared during the IEP process. That change would then be documented on the form by the therapist at the meeting. If the IEP team determines some other frequency and duration is needed to support the IEP other than what the therapist recommends, that can be documented in the minutes/written deliberations. However, the therapist’s written recommendations should be submitted into the student’s official record along with the final determination made by the committee, whether it is on the report or a separate form. That documentation will be important to the district over time if the IEP team has to consider setting limits on continuing demands from parent/guardian for therapy when 1) data shows that therapy is not making a difference or is no longer needed, or 2) the IEP team tries to meet parent/guardian concerns by providing therapy at a greater frequency/duration than the professional recommended but data indicates no additional benefit from the increase.  When the IEP team finally decides to say, “no,” there will be a record that the district made a good faith effort to meet the parent’s concerns.

Ethically [TBOTE Rule 374.4 (c) (3) and APTA Code of Ethics, Principle #3], and legally (IDEA law/regs and Texas laws/regs) you must recommend what the student needs in order to benefit from his special education, based on his evaluation, not allowing caseload/workload capacity factors to influence your recommendation. That is the first consideration. Once the ARD/IEP committee makes the final determination for service time/frequency/duration, the district must then figure out how it is going to provide the services. Assuming your schedule is efficient, your job is to let the district know your workload capacity, and when you no longer have capacity to add students. They have to then figure out how to serve what you and any OT colleagues in the district cannot. That does not mean you have abandoned the student per TBOTE Rule and are personally responsible for problem-solving how the student will be served.  The district has that responsibility. 

There is no requirement that a new evaluation be conducted when a student moves into your district unless your district does not receive a current evaluation and IEP. In fact, it is important that there be no interruption in services if at all possible.

Your question is a good one, as there is often confusion around this issue. 

Yes. Be sure that your documentation reflects what you did to evaluate the equipment for the student and your rationale for the recommendation you made not to use it. If the district has decided to proceed despite your recommendation, you must let go of the situation as it is no longer in your hands.