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OT primarily addresses fine motor skills, sensory processing, self-care, and functional participation in school-related activities (American Occupational Therapy Association [AOTA], 2020).

Autism spectrum disorder:

Why OT is needed: Students with ASD often struggle with sensory processing, fine motor skills, and daily life activities.

OT can include activities that help regulate and integrate sensory input, improving attention and focus.

OT Activities:

Fine motor (academic): Activities such as writing, drawing, cutting, and other fine motor tasks can be targeted to improve coordination and control.

Physical: Sensory integration therapy (e.g., using weighted vests or fidget tools).

Social-Emotional: Structured play activities to encourage peer interactions.

Private Occupational Therapy and Sensory Integration | The OT Centre - Learning Difficulties. (n.d.). https://www.theotcentre.co.uk/occupational-therapy-specialisms/learning-difficulties

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Counseling is a related service under the Individuals with Disabilities Education Act (IDEA), provided to students who require emotional, behavioral, or social support to access and benefit from their education. School-based counseling helps students manage emotions, develop coping strategies, improve social skills, and address mental health concerns (American School Counselor Association [ASCA], 2019).

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Speech therapy helps children improve their communication and language skills.

Speech therapy aims to improve

Early language skills

Ability for individuals to use their voice

language and comprehension

fluency

clarity and expression

Speech therapy focuses on the specific needs of a child determined by the speech-language pathologist diagnosis and treatment plan.

There are many speech therapy approaches (Cleveland Clinic, 2024).

Cleveland Clinic C. C. M. (2024, July 25). Speech therapy. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/22366-speech-therapy

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Targeted Classifications of Speech Therapy

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Targeted Classifications of Speech Therapy

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Speech therapy is recommended for individuals with speech and language disorders such as Apraxia, Articulation disorders, cognitive-communication disorders, expressive disorders, fluency disorders. (Cleveland Clinic, 2024).

Targeted Classification

Specific disability categories

Common targeted disabilities include

Speech or Language Impairment: used to support with difficulties of articulation, fluence, voice disorders and language impairments affecting comprehension or expression

Autism Spectrum Disorder: often needed to improve social communication, pragmatic language, and expressive-receptive language skills

Specific Learning Disability: language processing, reading comprehension, phonemic awareness and written expression

Intellectual Disability: support children with intellectual disabilities with functional communication, vocabulary expansion

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Targeted IDEA Classifications for Counseling Services

The following disability classifications under IDEA commonly require counseling services as part of an Individualized Education Program (IEP):

1. Emotional Disturbance (ED) – Students with anxiety, depression, or conduct disorders who struggle with emotional regulation.

2. Autism Spectrum Disorder (ASD) – Students with difficulty understanding social cues, self-regulation, or emotional expression.

3. Other Health Impairments (OHI) (e.g., ADHD, Anxiety, PTSD) – Students with executive function deficits, impulse control issues, or chronic medical conditions affecting mental health.

4. Specific Learning Disability (SLD) – Students with frustration due to academic struggles, leading to low self-esteem or school refusal.

5. Traumatic Brain Injury (TBI) – Students with emotional and behavioral challenges resulting from a brain injury.

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Occupational Therapy for Specific Learning Disability

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Occupational Therapy for Specific Learning Disability

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Why OT is needed: Many students with SLD have deficits in fine motor coordination that affect writing and organizational skills.

Example Student: A 10-year-old girl with dysgraphia who struggles to form letters correctly and fatigues quickly when writing.

OT Activities:

Academic: Keyboarding training and assistive technology for writing assignments.

Physical: Hand-strengthening exercises using playdoh or small toys.

Social-Emotional: Structured planning and time-management strategies.

Private Occupational Therapy and Sensory Integration | The OT Centre - Learning Difficulties. (n.d.). https://www.theotcentre.co.uk/occupational-therapy-specialisms/learning-difficulties

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Elementary Student Receiving Counseling Services

Student Profile:

Name: Alex, 8 years old, 3rd grade

IDEA Classification: Emotional Disturbance (ED)

Background: Alex experienced trauma due to family instability and frequently exhibits severe anxiety, emotional outbursts, and avoidance behaviors in the classroom. He often refuses to participate in group activities and has difficulty managing frustration.

Benefits Alex:

1. Academic Improvement:

Intervention: A school counselor helps Alex develop self-regulation strategies through deep breathing exercises and structured routines.

Outcome: Alex learns to manage stress before tests and stays engaged in class.

2. Social-Emotional Development:

Intervention: Weekly small-group sessions help Alex practice social skills, such as turn-taking and recognizing emotions.

Outcome: Alex begins forming friendships and communicating more effectively with peers.

3. Behavioral Support:

Intervention: Alex receives cognitive-behavioral therapy (CBT) techniques to manage anger and frustration.

Outcome: Alex decreases outbursts and learns problem-solving skills.

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Student: Age 7

Classification: Autism spectrum Disorder

Detail: Sam is a 7-year-old diagnosed with Autism Spectrum Disorder. struggles with pragmatic communication including asking for permission, speaking to classmates, and communicating needs. Sam sometimes can discern emotions but shows low accuracy in facial expression recognition.

Speech Therapy:

Speech therapy program includes a range of communication goals including support with pragmatic communication, learning non verbal skills such as signs or gestures.

Tongue and Mouth Exercises:

show student exercises and motions to strengthen mouth and tongue to train how to make coordinated patterns.

Facial movements:

teach child how to control the expression on their face to help improve motor skills.

Pragmatic communication

matching emotions with correct facial expressions

Responding to questions such as: How are you, whats' your name

Matching a picture with it's meaning

Role play: SLT coaches student with appropriate responses, facial expressions and how to answer questions such as greetings, informing of activities and making requestions. (Division of Speech-Language Pathology & Cincinnati Children’s Hospital Medical Center, 2015)

Impact

Sam attends speech therapy twice a week practicing pragmatic skills and role playing interactions to work with peers. This increases her confidence in social interactions, reducing anxiety and stress in pair or group activities. She is able to sit and parallel play with classmates, and can show some awareness of her classmates feelings, mostly identifying when a peer is happy or sad. She has been able to make one friend in the class, increasing her social interactions greatly since entering the class.

Speech therapy | Autism Speaks. (n.d.). Autism Speaks. https://www.autismspeaks.org/speech-therapy#:~:text=Speech%2Dlanguage%20therapy%20addresses%20challenges,more%20useful%20and%20functional%20ways.

Division of Speech-Language Pathology & Cincinnati Children’s Hospital Medical Center. (2015). Pragmatic language. https://www.cincinnatichildrens.org/-/media/Cincinnati-Childrens/Home/service/s/speech/hcp/doctor-info/information-language-PDF-pragmatic-lan-6.pdf

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Occupational Therapy for Intellectual Disability

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Occupational Therapy for Intellectual Disability

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Why OT is needed: Students with ID may struggle with self-care, motor planning, and independent functioning.

Example Student: A 12-year-old boy with Down syndrome who has difficulty buttoning his coat and organizing his school materials.

OT Activities:

Academic: Using color-coded folders to aid organization.

Physical: Fine motor exercises such as threading beads to improve dexterity.

Social-Emotional: Teaching self-help skills like dressing and hygiene in a structured setting.

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Other Health Impairments (OHI) (e.g., ADHD, Cerebral Palsy, Epilepsy)

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Other Health Impairments (OHI) (e.g., ADHD, Cerebral Palsy, Epilepsy)

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Why OT is needed: Conditions like ADHD or cerebral palsy can impact fine motor skills, self-regulation, and sensory processing.

Example Student: A 9-year-old with ADHD who fidgets excessively and struggles with impulse control.

OT Activities:

Academic: Implementing movement breaks and sensory-friendly seating options.

Physical: Gross motor games to improve coordination.

Social-Emotional: Deep breathing and mindfulness activities to improve self-regulation.

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Why OT is needed: Students with multiple disabilities often require assistance with mobility, daily living skills, and adapted classroom participation.

Example Student: A 6-year-old with cerebral palsy and visual impairments who has difficulty with self-feeding and using classroom materials.

OT Activities:

Academic: Using adapted tools like slant boards and large-print materials.

Physical: Hand-over-hand guidance for self-care activities.

Social-Emotional: Facilitating peer interaction through adapted play activities.

Private Occupational Therapy and Sensory Integration | The OT Centre - Learning Difficulties. (n.d.). https://www.theotcentre.co.uk/occupational-therapy-specialisms/learning-difficulties

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How the Assessment Process Determines Counseling Needs in an IEP

A student's need for counseling as a related service is determined through multi-tiered assessments that evaluate emotional, behavioral, and psychological challenges.

1. Behavioral & Emotional Assessments

Example: Behavior Assessment System for Children (BASC-3)

How It Helps: Measures anxiety, aggression, and emotional regulation difficulties to determine if counseling is required.

2. Functional Behavior Assessment (FBA)

Purpose: Identifies the root causes of problem behaviors and triggers.

Application for Alex: Observations confirm that Alex shuts down when frustrated with difficult tasks, indicating the need for coping strategies through counseling.

3. Teacher & Parent Reports

Example: Social Skills Rating System (SSRS)

How It Helps: Identifies social skill deficits and emotional concerns that impact classroom behavior.

4. Direct Student Interviews & Self-Reports

Purpose: Evaluates the student's perception of their own emotions and school experiences.

Application for Alex: A student interview reveals that he feels overwhelmed and unsupported, reinforcing the need for counseling interventions.

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American School Counselor Association (ASCA). (2019). The school counselor and students with disabilities. Retrieved from https://www.schoolcounselor.org

Gresham, F. M., & Elliott, S. N. (2008). Social Skills Improvement System (SSIS) Rating Scales. Pearson Assessments.

Kamphaus, R. W., & Reynolds, C. R. (2015). Behavior Assessment System for Children (BASC-3). Pearson.

Sugai, G., Horner, R. H., & Lewis, T. J. (2010). Functional behavior assessment and behavior support plans. Journal of Emotional and Behavioral Disorders, 18(1), 3-13.