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Occupational Therapy at the middle school level focuses on academics, self-care skills (for some students), play and leisure, and social participation. Occupational Therapy services help students with sensory processes, social skills, and fine motor skill in the educational setting. OT has a few different ways to be incorporated such as push-in models, collaboration, flexibility, positive reinforcement, and individualized plans. 

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Disability Classifications:

Emotional/Behavioral Disability (EBD): needing support in social areas and organizational skills.

Other Health Impairment (OHI): needing support in health conditions that make participating in school difficult.

Autism Spectrum Disorder (ASD): needing support in sensory processing, transitions and routines, and social challenges.

Orthopedic Impairment (OI): needing support with accessing and participating in school activities.

Hearing Impairment/ Deafness: needing support with communication challenges.

Visual Impairment/Blindness: needing support with accessing and participating in school activities.

Students Who Would Benefit from the Services:

Emotional/Behavioral Disability (EBD): Oppositional Defiant Disorder (ODD), Bipolar disorder, students with high anxiety, depress, and self- harm.

Other Health Impairment (OHI): Chronic Health Conditions, ADHD, Leukemia, diabetes, epilepsy, sickle cell anemia.

Autism Spectrum Disorder (ASD): Asperger's Syndrome, Autistic Disorders

Orthopedic Impairment (OI): Spina Bifida, Cerebral Palsy, and Muscular Dystrophy.

Hearing Impairment/ Deafness: sensorineural hearing loss and conductive hearing loss.

Visual Impairment/Blindness: levels of blindness (legally, low, complete, retinitis, congenital, and strabismus).

Activities to Improve Academic, Physical, and Social-Emotion:

Emotional/Behavioral Disability (EBD): using social stories , group activities, musical therapy, organized play dates, mediation, role-playing.

Other Health Impairment (OHI): practicing handwriting, cutting, using arts and crafts, playing with play dough, slime, other sensory textured material.

Autism Spectrum Disorder (ASD): tactile simulation, using timers, visual aids, managing a schedule, role playing activities.

Orthopedic Impairment (OI): coming up with access plans, role playing, flexibility, and push-in models.

Hearing Impairment/ Deafness: visual aids, social stories, and push-in model, and using technology to help communicate.

Visual Impairment/Blindness: Using technology to help communicate, music therapy, timers, familiarization of a routine or plan.

Assessments:

Bruininks-Oseretsky (BOT-2): This is a test of the level of motor skills in a student. This assessment looks at the fine and gross motor skills of students from the age 4 to 21 years old. This will also tell us what deficits the student has with particular motor skills which will help us create a plan for them.

School Function Assessment (SFA): this is an assessment to measure a student's performance on functional tasks.

Beery VMI: this assessment measures a student's visual and motor skills.

TVPS-4: this is an assessment to test a students visual ability and processing skills.

DTVP-3: this is an assessment evaluating visual perception and motor skills.

ETCH: evaluating handwriting skills, and speed.

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Physical therapy is a related service that is available to students under the IDEA. The role of physical therapy in middle school is to improve students gross motor skills, mobility, participation and involvement in school. 

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Disability Classifications

Physical: students that have difficulty function, mobility, and movement.

Behavioral: students that struggle with regulating their emotions, behaviors, and interactions with others.

Other Health Impairment (OHI): students with health issues such as heart disease and diabetes, etc.

Learning: students who are not able to process information in the same manner.

Speech and Language: students who have difficulty with language comprehension or speech production.

Students Who Would Benefit From the Services

Physical: students in wheel chairs, leg braces, etc.

Behavioral: ODD, anxiety

Other Health Impairment (OHI): ADHD, epilepsy, autism

Learning: Traumatic Brain Injuries

Speech and Language: Stuttering, language impairments

Activities to Improve Academic, Physical, and Social-Emotion

Physical: for students in a wheel chair we can conduct routines and exercises that are seated and strengthening. Also using adaptive sports, and modifying activities. Example: playing field hockey with a stick that will match the height of the student in their wheel chair.

Behavioral: Physical therapy can help students with ADHD because it could help promote relaxation and deep breathing and reduction in stress. Example: Box breathing (4 seconds inhale, 4 seconds hold, 4 seconds exhale)

Other Health Impairment (OHI): Students with autism could benefit from physical therapy can promote social skills and a way to communicate nonverbally. Example: mirror exercises, having the student mimic movement.

Learning: For students who have traumatic brain injuries physical therapy could improve motor skills, balance, and cognitive abilities. Example: star jumps which gets the students arms and legs moving.

Speech and Language: physical therapy could improve posture, articulation, and overall communication. Example: blowing bubbles, and tongue twisters.

Assessments

Range of Motion (ROM): assessing joint movement and the students strength in their muscles.

Gross Motor Assessment: looking at the students coordination (walking, running, and jumping).

Sensory Assessment: this test to see the students process of sensory.

SFA (school function assessment): testing the students ability to function in school based activities.

Functional Assessments: testing the way students are able to complete daily activities such as eating, using the restroom, and getting dress.

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1. Emotional Disturbance (ED)

Service Type: Direct
Counseling Service: Individual or group therapy focusing on emotional regulation, coping skills, and behavioral management.
Explanation:
Students classified under Emotional Disturbance often experience anxiety, depression, or aggressive outbursts that impact learning and social interactions. Direct counseling helps them regulate emotions, understand triggers, and develop healthy behaviors. These services are essential to support their participation in the general education setting.

2. Autism Spectrum Disorder (ASD)

Service Type: Direct
Counseling Service: Social skills training (small group or 1:1)
Explanation:
Students with ASD may struggle with social cues, peer relationships, and communication. Direct counseling through structured social skills groups helps them practice conversation, emotional recognition, and appropriate responses. These skills are critical for inclusion and peer interaction.

3. Attention-Deficit/Hyperactivity Disorder (ADHD)

(typically classified under "Other Health Impairment")
Service Type: Direct or Indirect
Counseling Service: Executive functioning coaching, behavior intervention consultation
Explanation:
Students with ADHD benefit from counseling that targets organization, planning, self-monitoring, and attention. Direct coaching helps the student develop skills, while indirect consultation supports teachers in implementing behavior strategies. These interventions help maintain focus and improve task completion.

4. Specific Learning Disability (SLD)

Service Type: Indirect (consultation with staff); sometimes Direct (academic motivation, coping with frustration)
Counseling Service: Academic motivation support, self-advocacy skills, and stress management
Explanation:
Though the primary need is academic, students with SLD often experience frustration, low self-esteem, or anxiety about schoolwork. Counseling supports emotional well-being and builds resilience, improving engagement and perseverance with challenging tasks.

5. Intellectual Disability (ID)

Service Type: Direct
Counseling Service: Adaptive behavior counseling, social-emotional instruction
Explanation:
Students with ID may have difficulty understanding appropriate behavior in different settings. Direct counseling helps build basic social and emotional understanding, fostering independence and improving functioning within both special education and inclusive classrooms.

6. Traumatic Brain Injury (TBI)

Service Type: Direct
Counseling Service: Cognitive-behavioral therapy (CBT), grief and trauma support
Explanation:
TBI can result in mood swings, memory loss, frustration, and impulse control issues. Counseling helps students process the trauma, cope with cognitive challenges, and improve emotional stability — all critical for reintegrating into learning environments.

7. Speech or Language Impairment

Service Type: Indirect
Counseling Service: Collaboration between counselors and SLPs to support self-confidence and reduce anxiety in communication
Explanation:
Students with communication challenges may experience social withdrawal or anxiety. While speech-language pathologists target communication skills directly, school counselors provide support around self-esteem and social participation.

8. Multiple Disabilities

Service Type: Direct and Indirect
Counseling Service: Integrated social-emotional counseling; family support services
Explanation:
Students with multiple disabilities have complex and overlapping needs. Counseling helps manage emotional and behavioral responses to their environment, while indirect services include collaboration with families and staff to create consistent support systems.

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School Work: The counsellor who gives students a safe space

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Counseling-Related Services for John – Supporting Academic, Physical, and Social-Emotional Growth

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Counseling-Related Services for John – Supporting Academic, Physical, and Social-Emotional Growth

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Student Profile:
Name: John
Grade: 7
Year of Enrollment: 2021
English Proficiency: Fluent
First Language: Mandarin

Counseling-Related Services and Activities

1. Individual Counseling

Activities:

Behavioral Reflection: Discuss incidents of inappropriate behavior to understand triggers and consequences.

Goal Setting: Set specific behavioral goals, like improving respect for authority and reducing impulsivity.

Expected Outcomes:

Academic Achievement: Improved focus in class, leading to better homework and test performance.

Social-Emotional Well-Being: Increased self-awareness and accountability for actions, contributing to emotional stability.

2. Group Counseling

Activities:

Peer Interaction: Participate in sessions focused on social skills, addressing disrespect and impulsivity.

Conflict Resolution: Engage in role-playing to practice appropriate responses to authority figures and peers.

Expected Outcomes:

Social Well-Being: Enhanced social skills, leading to better peer relationships and reduced conflicts.

Emotional Well-Being: Greater understanding of respectful communication, fostering positive interactions.

3. Academic Support and Monitoring

Activities:

Homework Assistance: Weekly check-ins for assignment completion and content understanding.

Study Skills Workshops: Workshops to develop effective study habits and time management.

Expected Outcomes:

Academic Achievement: Improved completion rates for homework and assessments, aiming to raise grades from low scores to passing levels.

Physical Well-Being: Reduced stress related to academic performance, contributing to overall well-being.

4. Crisis Intervention

Activities:

Safety Planning: Develop a safety plan for coping with feelings related to physical abuse at home.

Regular Check-Ins: Monitor John's emotional well-being through scheduled sessions.

Expected Outcomes:

Emotional Well-Being: Greater emotional stability and resilience in handling home issues.

Behavioral Improvement: Reduced disruptive behavior, leading to a more conducive learning environment.

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Counseling- How Assessments Determine the Need for Counseling-Related Services

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Counseling- How Assessments Determine the Need for Counseling-Related Services

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1. Diagnostic Assessments Identifying Emotional, Cognitive, and Behavioral Concerns

Formal assessments such as:

WISC (Wechsler Intelligence Scale for Children): Measures cognitive abilities like working memory and processing speed. For this student, low scores in these areas may lead to frustration and classroom avoidance, indicating a need for counseling focused on academic self-esteem, self-advocacy, and emotional regulation.

WIAT (Wechsler Individual Achievement Test): Assesses academic skills in reading, writing, and math. A significant discrepancy between WISC and WIAT scores would suggest a learning barrier that can cause anxiety and feelings of failure, supporting the need for counseling to build resilience and coping strategies.

Woodcock-Johnson: Offers a broad view of cognitive processing and academic achievement. Specific weaknesses (e.g., in auditory processing or processing speed) could explain academic underperformance and behavioral acting-out, leading to counseling for frustration tolerance and behavioral regulation.

In addition, behavioral and emotional screeners like the Behavior Assessment System for Children (BASC-3) or the Strengths and Difficulties Questionnaire (SDQ) help assess emotional regulation, externalizing behaviors (e.g., impulsivity), and internalizing concerns (e.g., trauma from reported abuse at home). These tools further support the need for individual and trauma-informed counseling.

2. Behavioral Observations and Discipline Records (Informal/Formative Assessments)

The student’s repeated behavior incidents — including spitting on the classroom floor, inappropriate language, lying, and technology misuse — are documented in behavior logs and teacher notes. These informal assessments show:

Persistent impulsivity and defiance

Attention-seeking behavior likely related to unmet emotional needs

This behavioral data confirms the need for counseling that targets self-regulation, anger management, and respectful communication.

3. Academic Data (Summative Assessments)

Academic performance is consistently below expectations:

English: 4 out of 8

Math: 3 out of 8

Incomplete homework and missed assessments

This underachievement, combined with emotional distress, points to learning disruptions that counseling can address by:

Teaching study strategies and organizational skills

Reducing test anxiety and academic avoidance

Helping the student set academic goals and build confidence

4. Functional Behavior Assessment (FBA)

Due to frequent behavioral incidents, an FBA would be appropriate to identify:

The function of behavior (e.g., escape, attention, sensory)

Triggers (e.g., transitions, feedback from adults)

Replacement behaviors and targeted supports

This would lead to a Behavior Intervention Plan (BIP) supported by counseling focused on:

Impulse control

Emotion identification

Behavioral goal-setting