Under the Individuals with Disabilities Act (IDEA), occupational therapy and physical therapy are considered as related services. Related services are those that are deemed necessary for a child to make progress on goals/objectives. Intervention in the education setting is not provided to remedy dysfunction under IDEA, but instead to help the student achieve his/her learning and participation goals. Schools are responsible only for those services necessary for the student to make progress in his/her special education program. Discontinuation of related services may occur when skills needed have been incorporated into school routines, when needed supports are in place without the addition of services or when the student no longer needs related service support to progress on goals/objectives.
Based on state and professional licensing laws, a prescription (also referred to as a medical or medical order) for physical therapy services must be obtained from a “qualified healthcare practitioner licensed by the appropriate licensing board, who within the scope of the professional licensure is authorized to prescribe treatment of individuals…qualifying referral sources includes physicians, dentists, chiropractors, podiatrists, physician assistants, and advanced nurse practitioners.” (§322.1 Provision of Services: PT Act and Rules) before an OT and/or PT evaluation or treatment can occur.
Occupational therapy services may or may not require a prescription depending on the treatment and medical condition of the individual being served as well as depending on the facility’s policy.
“Treatment for a medical condition by an OT requires a referral from a licensed referral source” whereas “consultation, monitored services, and evaluation for need of services may be provided without a referral” as well as “non-medical conditions….however a referral must be requested at any time…when necessary to insure the safety and welfare of the consumer”. (§372.1 Provision of Services: OT Rules)