Occupational Therapy - Initial Referral

Occupational Therapy (OT) | Initial Referral

School-based occupational therapy (OT) supports the student's ability to gain access to and make progress in the school curriculum. OT supports a child's engagement and participation in daily occupations, which includes activities in daily living, education, prevocational work, work, play, rest, leisure, and social participation. OT works on mediation (improving sensory and motor foundations of learning and behavior) to help the child succeed in school.

 

 Pre-Referral

  • Convene an Individualized Education Program (IEP) meeting to document the team's decision to refer the student for an OT assessment.
  • Complete the Occupational Therapy Referral form (D/M 120A) and obtain the signatures of the person making the referral and the director of special education.
  • Complete the Assessment Plan form (D/M 66) and obtain the parent/guardian signature.
  • The person making the referral should check the box that corresponds to the type of assessment(s) requested.
  • The parent/guardian should initial each applicable statement listed under the Parental Authorization section of form D/M 66.
  • It is important that the parent/guardian return the form to the LEA on the date that it is signed or as soon as possible thereafter. When the signed Assessment Plan is received by the LEA, it should be date stamped.
  • Complete the Authorization for Use and/or Disclosure of Information form (D/M 63) and obtain the parent/guardian signature. Specify the receiving agency's name, if known. If not, leave the field blank.

 

Timeline for Assessment

Within five business days of receipt of the completed referral packet, the Program Manager, Due Process at the SELPA, will forward it to a SELPA occupational therapist.

Referral

  • D/M 120A Occupational Therapy Referral form
  • D/M 66 Assessment Plan form
  • D/M 63 Authorization for Use and/or Disclosure of Information form
  • IEP or IEP Addendum dated within one year of the of the referral for occupational therapy
  • Psycho-educational evaluation dated within three years of the referral for occupational therapy
  • Any additional supporting information

 

Timeline for Services

Upon completion of the OT assessment, a report will be sent to the director of special education by either the occupational therapist that conducted the assessment or the Program Manager, Due Process at the SELPA with a request to schedule an IEP meeting.

The director of special education will reconvene the IEP team to determine whether or not services are warranted.

If the IEP team agrees that services are not needed, it will be documented in the IEP notes.

If the IEP team agrees that services are appropriate, the services should be listed on an Addendum to the IEP including the projected start date, duration, and frequency. The Addendum should be forwarded to the Program Manager, Due Process at the SELPA.

Within five business days of receipt of the Addendum to the IEP, the Program Manager, Due Process at the SELPA will develop an Individual Service Agreement (US) for signature and forward it to the occupational therapist or the appropriate Nonpublic Agency (NPA) for signature who will then assign a therapist and determine initiation of services. The SELPA will enter the OT services into the SELPA Management Information System (MIS) database.

For more information, please contact our office at (760) 552-6700