Welcome to the final post in our three-part series on developing present levels, goals, accommodations, and determining service frequency. In our previous posts, we discussed the importance of writing effective Present Levels of Performance (PLOPs) and using them to develop effective accommodations and therapy goals for our students.
In this post, we will focus on using those PLOPs, accommodations, and therapy goals to determine an appropriate occupational therapy service frequency for each student. Occupational therapy service frequency refers to how often a student receives occupational therapy services, and it's a critical factor in ensuring that students receive the support they need to achieve their goals.
We'll provide practical tips and an exercise you can use for determining an appropriate occupational therapy service frequency for each student based on their unique needs and goals. By the end of this post, you'll have a clear understanding of how to use PLOPs, accommodations, and therapy goals to determine an appropriate occupational therapy service frequency for each student, which will help ensure that they receive the support they need to succeed.
So let's dive in and learn how to determine the appropriate occupational therapy service frequency for your students!
Part Three: Frequency of Services
One of the most challenging parts of being a school-based OT is deciding the frequency at which we should see a student.
As much as we want to make the determination of service frequency a black-and-white process by using a magic calculator or formula, this process is very subjective and complex.
One goal does not equal once-a-month consults, and having three IEP goals does not automatically mean a student requires weekly services. With that said, more complex goals may warrant more frequent therapy sessions.
There are many factors to consider, such as:
How many goals does the student have?
How old is the student?
Who is the teachers, and can I collaborate with them?
Will there be carryover from the team?
And more...
And we are just talking about frequency, not where the service will take place or what tools we will use during therapy.
I have found the best way to determine the frequency for each student is to use the student's Present Levels of Performance (PLOPs), accommodations and modifications, and therapy goals as a guide.
In the last email, I shared how we can use the PLOPs to lead to goals and accommodations, so we will start there in this email. Remember, areas of concern often lead to goals, while areas of strength may lead you to think of some reasonable accommodations to support those goals.
Once you have your goals and accommodations in place, it is time to determine how you will implement the accommodations and support the student in reaching the goals.
Starting with the accommodations, ask yourself these questions:
How complex is the accommodation to learn?
Who will I need to train in the use of the accommodations? Will you train the teacher, and the teacher teaches the student? Or will you have to train everyone?
Will you have to order the tool?
How will you know when training is no longer needed, and the tool is being used adequately?
Based on the answers to these questions, you may only need to meet with the teacher once a month to implement the tool. Or you may need to see the teacher and student every week for several weeks.
Want to learn more about developing strong present levels, goals, and services?
Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best.
Goals to Services
Moving on to services, it gets more tricky - especially if you do not yet know the student well.
Every child develops uniquely and learning what they can accomplish in what time frame takes time.
Ideally, we are supposed to determine services in a way that keeps the student in their educational environment as much as possible while also making "meaningful progress" (as referenced in many court cases) toward the student's IEP goals.
We may be experts in child development, but we aren't Tarot Card reads. We can't predict what the student will accomplish one year from today. At least, I can't.
So when it comes to determining services, this is the exercise I use. Feel free to use it for yourself.
I ask myself a series of questions starting with the least restrictive service frequency.
Is the student likely to meet their goals (or make meaningful progress toward their goals) if I meet with them or their teacher only once a month? If so, that is where I start - with a once-a-month service or consult.
But if not, I ask: Is the student likely to meet their goals (or make meaningful progress toward them) if I meet with them or their teacher twice a month? If not...
Is the student likely to meet their goals (or make meaningful progress toward their goals) if I meet with them or their teacher 3 or 4 times a month?
Three questions. That's not too bad, yeah?
From there, if the answer is still "No, I do not think the child will meet the goals with services once a week." Then there are a few things you can do.
Before asking if twice a week is required (don't scream at me, I know you don't even want to hear that... well, most of you), first ask if just one additional consult a month would make a difference.
I have found that when I see a student weekly, some things don't carry over into the classroom. But good things seem to happen when I add one consult a month to my weekly services. So, maybe start there.
You may also ask yourself if the goals you and the IEP team are putting in place are over the top - either in their quantity or in the student's ability range.
When a single service provider has more than three goals they are responsible for, I find that they don't always get worked on. There are always other goals to work on, but the IEP team must determine what is most important this year. It's okay to say to the IEP team, "I was considering a goal to _____, but the goal I wrote is most important now. Maybe next year we can focus on _____."
I know we did not dive into the topics of consult vs. collaboration and how long sessions should be. We can do that another time. Or, if you'd like to learn more about that and more with me right now, check out my course - A-Z School-Based OT Course.
The A-Z School-Based OT Course is perfect for you if you're headed into a position as a school-based OT practitioner or if you have been there awhile and feel like you need some support being the confident therapist you want to be.
I've supported nearly 1000 OT practitioners via this course and would love to help you, as well.
See ya next time,
👋 Jayson
Learn more about developing strong present levels, goals, and services.
Sign up for the A-Z School-Based OT Course to help you better understand school-based OT and to create systems to ensure you are giving each student your absolute best.
