Children are born ready to learn different skills in each development milestone. They are expected to learn these skills from parents/caregivers and the environment that surrounds them. Parents and caregivers are the best teachers for children to learn different skills. Children vary in reaching milestones, some are quicker than others. In this case, we are focusing on children’s speech development.

Children start learning a language at an early stage and they learn through the people who surround them. Children learn different language skills like giggles, repeating sounds, and telling stories. All these language skills that children learn in different milestones lead to language development. Skills help children to learn to understand what others are saying and communicate their thoughts ( IRIS Centre).

Some children take a long time to master the language, this might lead to speech and language difficulties ( IRIS Centre).

Speech and language difficulties occurs due to language delays during speech and language development. Neurological disorders, brain injury, or intellectual disabilities can lead to speech and language difficulties. The combinations of speech and language difficulties can present negative impact on student academic development.

Some learning disorders are associated with delays in speech and language development. For example autism, emotional and behavior disorders, and specific learning disorders in language. Parents and caregivers need to observe children's development closely. To see if there are reaching the developmental milestones at the expected time.

Speech and language difficulties can be categorized into four areas which are receptive language, expressive language, social communication, and reading and spelling. A student might struggle with one or more of these areas which affect their academic performance( Belsky, Understood).

This service aimes at improve communication skills , does not only deal with pronunciation however helps students who are struggling with spoken and written language. Speech and Language Pathologist are responsible with providing this service to students ( Belsky, Understood). It is a type of service provide support to assist students who have speech, language  and hearing 
disabilities. The students can have a mild or severe, depending on the level of problem.

There are different types of services tha includes

What do they do ?
 A goal of speech-language pathology services is to help students who have trouble with communication skills perform important learning and school-related activities ( IRIS, Centre). 
Most of the time students struggles in these areas

The speech and language pathologist aims at developing speech and language skills that will improve the conditions of the students. They don't only focus on academic area only , they also look on social aspect of student development.

Speech and Language Pathologist work with general teachers, special aid teachers , and parents to make sure that they know how to support the students.

Centers for Disease Control and Prevention. (2022, May 11). Language and speech disorders in children. Centers for Disease Control and Prevention. Retrieved May 24, 2022, from https://www.cdc.gov/ncbddd/developmentaldisabilities/language-disorders.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fncbddd%2Fchilddevelopment%2Flanguage-disorders.html 

Sec. 300.34 related services. Individuals with Disabilities Education Act. (2017, May 2). Retrieved May 25, 2022, from https://sites.ed.gov/idea/regs/b/a/300.34 

(IRIS | Page 6: Occupational Therapy Services, n.d.)

(IRIS | Page 6: Occupational Therapy Services, n.d.)

(Occupational Therapy Fact Sheet, n.d.)

Visual Motor & Visual Perception
What?
Visual perceptual skills enable a child to make sense of and interpret what they are seeing.  These skills include:

Why?
Visual motor skills enable a child to coordinate their eyes and hands to draw and write. Children may have difficulty with copying shapes, handwriting, lining up math problems, etc.

How?
Providing slant boards, giving special writing paper, supplying colored reading strips, suggestions for proper font size, giving visual-motor exercises to complete throughout the day, etc.


Executive functioning skills and attention
What?
Executive function and self-regulation skills are the mental processes that enable us to plan, focus attention, remember instructions, and juggle multiple tasks successfully. (Executive Function & Self-Regulation, 2020)

Why?
These skills are crucial to organize information to process, and to plan and carry out an activity from the beginning to the end. Executive function skills depend on two types of brain function: working memory, and mental flexibility. These functions are highly interrelated, and the successful application of executive function skills requires them to operate in coordination with each other.

How?
Meeting with the students to create schedules and planners, creating ways for the student to stay organized, helping student declutter their desks and lockers and coming up with an organization system for them, working on time management techniques for timely completion of tasks,  modifying the environment by offering different placement of the desk or a cushion for the child to sit on, infusing more physical activity throughout the school day, breaking down a task into its key components and offering classroom instruction in parts or with simple directions, breaking down tasks into smaller steps, etc.

Behavior management/self-regulation
What?
Behavior management focuses on maintaining positive habits and behaviors and reducing negative ones.

Why?
To create an appropriate environment for learning to take place and to guide behavior management in individuals and groups toward fulfilling, productive, and socially acceptable behaviors.

How?
Coping strategies, curriculum like Zones of Regulation, positive reinforcement strategies, clear boundaries and consequences, positive self-talk, modeling,  etc.

Social skills
What?
Social skills are the skills we use to communicate and interact with each other, both verbally and non-verbally, through gestures, body language and our personal appearance. (What Are Social Skills? | SkillsYouNeed, n.d.)

Why?
To have more positive and supportive relationships with peers and community members.

How?
Social Thinking training, problem solving training, perspective taking training, positive conflict resolution strategies, functional language training, etc.

Independent living skills (including transition needs) & daily routines
What?
Life skills are those abilities that help to deal with challenges in life and to promote physical, mental, and emotional well-being and competence. There are a wide range of life skills and definitions are usually broad and generic. Life skills can be cognitive, behavioral, emotional, personal, interpersonal, or social. The five main life skills areas defined by WHO Department of Mental Health are decision-making and problem-solving; creative thinking and critical thinking; communication and interpersonal skills; self-awareness and empathy; and coping with emotions and stress. These skills may generally be classified in three basic dimensions:

Why?
Achieving essential life skills is crucial in order to adapt to changing environmental conditions and meet the demands. Life skills contribute to the development of self-efficacy, self-confidence, and self-esteem by helping students to understand and respond different situations, and to work towards living independently in the future.

How?
Evidence-based life skills programs, using methods such as role play, feedback about performance, practice of skills instead of just using didactic teaching, starting with skills learning in nonthreatening situations and progressively moving on the practice of skills in high-risk situations, adapting clothes and feeding utensils for increased independence, teaching fun songs for tying shoes, washing hands; budgeting strategies, spatial adaptation to support map navigation, etc.

(Huri, 2017b)

Sensory-processing challenges
What?

Why?
The occupational therapy practitioner has expertise in assessing the sensory components that are all around us, whether it’s sounds, smells, textures, movements. This is what we typically receive and filter and accommodate all day, every day. But the student with a sensory challenge might find certain smells or textures irritating, and this might lead to inattention or oppositional behavior.

How?
Slowly introduce different classroom textures and create an individualized  “sensory diet” per student needs to accommodate and remediate some of this hypersensitivity that the student is showing to sensory information, collaborate with the teachers to try to address the sensory needs throughout the school day, alternate seating options, auditory accommodations for increased focus, fidgets or weighted items for increased attention and/or transitions, providing accommodations for tactile feedback during classroom tasks, supplying oral suggestions to help quiet and calm the mouth, etc.

Transition
What?
Why?
How?

Assistance with Adapted Equipment
What?
Adaptive equipment is any tool, device, or machine that is used to help with any task associated with daily living. Assistive devices can be created or purchased so long as they achieve the end result of making tasks possible for people with disabilities.
There are various kinds of adaptive equipment. These fall under several categories depending on the type of assistance they give.

Why?
To assists individuals with daily living, and to make the job of writing, cutting, being a student in the classroom easier.

How? (some examples)

(BraunAbility, 2021)
(IRIS | Page 6: Occupational Therapy Services, n.d.)
(Finlan, 2020)
(Calhoun, 2022)
(Visual Motor / Perception | Occupational Therapy and Physical Therapy, n.d.)

BraunAbility. (2021, June 3). What Is Adaptive Equipment? How Adaptive Equipment Helps in Your Daily Life. https://www.braunability.com/us/en/blog/accessible-living/what-is-adaptive-equipment.html

Calhoun, T. (2022, April 4). OT Month – Helping Children Within a School Setting | PT Services. PT Services Rehabilitation, Inc. https://www.ptsrehab.com/ot-month-helping-children-within-the-schools/

College of Occupational Therapists of Ontario. (n.d.). What Occupational Therapists (OTs) Do. COTO. Retrieved May 26, 2022, from https://www.coto.org/you-and-your-ot/what-occupational-therapists-do

Executive Function & Self-Regulation. (2020, March 24). Center on the Developing Child at Harvard University. https://developingchild.harvard.edu/science/key-concepts/executive-function/#:%7E:text=Executive%20function%20and%20self%2Dregulation,and%20juggle%20multiple%20tasks%20successfully.

Finlan. (2020, January). Occupational Therapy (for Parents) - Nemours KidsHealth. KidsHealth. Retrieved May 26, 2022, from https://kidshealth.org/en/parents/occupational-therapy.html

Huri, M. (2017b). Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation. InTechOpen.

IRIS | Page 6: Occupational Therapy Services. (n.d.). Iriscenter. https://iris.peabody.vanderbilt.edu/module/rs/cresource/q2/p06/#content
Kim, & Ponsolle-May. (2021). Case Example – Occupational Therapy in School-Based Practice. Case Example- School-Based Practice, 1(1), 1–9. https://www.ilota.org/assets/Case%20Example-%20School-Based%20Practice%20041421.pdf

Occupational Therapy Fact Sheet. (n.d.). NSWgov. https://education.nsw.gov.au/teaching-and-learning/disability-learning-and-support/programs-and-services/specialist-allied-health-service-provider-scheme/user-guide-for-schools/scheme-details/allied-health-in-schools/occupational-therapy-fact-sheet#What2

Visual Motor / Perception | Occupational Therapy and Physical Therapy. (n.d.). Cincinnati’s Children. Retrieved May 26, 2022, from https://www.cincinnatichildrens.org/service/o/ot-pt/visual-motor-perception#:%7E:text=Visual%20perceptual%20skills%20enable%20a,ability%20to%20remember%20visual%20information

Wen, Craig, Gottlob, Kneuer, Perry, Piper, Read, Romero, Roush, Sale, & Wimmer. (2020). Occupational Therapy Manual for the EASA Model. Early Assessment& Support Alliance, 1(1), 1–13. https://easacommunity.org/PDF/OT-Manual.pdf

What are Social Skills? | SkillsYouNeed. (n.d.). SkillsYouNeed. https://www.skillsyouneed.com/ips/social-skills.html

This article will focus on school-based physical therapy (PT).

Who determines eligibility for this service?
Eligibility falls under two laws - IDEA and ESSA. IDEA, Individual with Disability Act, guarantees free and public  education to students with disabilities. It also states that to students should receive interventions in the least restrictive environment (LRE) which means PT services can be provided within the school. 
ESSA, Every Student Succeeds Act, that holds schools accountable for providing high-quality education for all students. This means schools should plan for and provide services for students with disabilities to ensure that they have full access to education programs provided by the school.
Students with disabilities and have limitations in accessing education qualify or are eligible for school-based PT.

These group of students will benefit to work with Speech Language Pathologist.

For example : A child who is struggling reading depending with age of the child. SLP will start teaching sound and SLP make sure that the child does the movement with his mouth. For each sound has got it own movement. this will help the child to differentiate sounds.SLP will use touch , visual and listening method to help child to learn sounds.

He has high energy at school and is excited to be around his teacher and peers. He is experiencing challenges with social interaction skills. He struggles with understanding and demonstrating expected social behaviors in the classroom and other school contexts. These social interaction challenges are affecting his occupations while at school – formal education participation, community participation, and peer group participation. He keeps getting up during class to talk to his classmates,” and is having a hard time maintaining a safe physical distance from his peers. Additionally, his teacher reported that he frequently talks without raising his hand or being called on. When talking to his classmates, he tends to dominate conversations, and does not pay attention when other students are talking to him.

He will become aware of social rules in the classroom by listening to his teacher and following the  classroom instructions.

He will become more aware of others’ perspectives by respecting their space and demonstrating cooperative interaction during activities with peers. 

He will demonstrate improved executive function, specifically self-management skills such as keeping his hands/feet to himself and reduced interfering behaviors, in the classroom.

Occupational therapy services might be discontinued when he no longer has adverse needs impacting his education that would need to be addressed through occupational therapy. This might happen after he has met his short- and long-term goals or other services are implemented that would sufficiently meet his needs. OT services may also be discontinued if his parents choose for him to no longer have an IEP.

(Kim & Ponsolle-May, 2021)

Allergies - Epi pen, medicine

Diabetic - blood test, insulin

ADHD - medicine

Epilepsy - aid during seizures, medicine

A guest nurse was on duty in the office. The nurse consulted John’s 504 plan and reviewed what his insulin schedule was and what his treatment plan was if his blood sugar was low from too much insulin being in his system. 

In addition to shakiness and blurred vision, other symptoms that were notated in John’s plan included: anxiety, swating, chills, fatigue when his blood sugar became too low. The nurse knew that other things such as nausea, hunger, anger, stubbornness can also be signs that a diabetic student needs treatment for diabetes in order to remain in school.

The nurse checked John’s blood sugar and confirmed that John had too much insulin in his system, a sure sign that his blood sugar was too low. The nurse gave John 4 ounces of orange juice and rechecked his blood sugar in 15 minutes. It was still low so he decided to provide two glucose tablets and check again in 15 minutes. 

The nurse then proceeded to call John’s parents, but told them that John should be ready to go to his next class, and that proved to be the case that John could go to his next class about 40 minutes after entering the office.

Without a nurse on campus, John may have missed the rest of the day.