Related Services and Therapies

A young boy listens to the sounds he can create with the guitar strings.
A young boy listens to the sounds he can create with the guitar strings.

Children with significant disabilities should have access to these related services among other possible services as determined by the IEP team:

    • speech-language pathology and audiology services
    • physical and occupational therapy
    • recreation, including therapeutic recreation
    • art, music, and dance therapy
    • orientation and mobility services
    • parent counseling and training

Additionally vision and hearing services from certified teachers of students who are deaf and hard of hearing, blind and visually impaired or deafblind may be provided to students with hearing or vision impairments.

So what are the roles of specific related service staff, therapists, and specialized teachers as it relates to using an Active Learning approach?

Assessment

If there is a suspected disability of any kind, assessment should be done to determine eligibility and need. Most districts have certain assessment tools they use regularly and many of these tools can provide information about the child’s present levels of functional performance. These assessment tools can help the team in completing the Functional Scheme assessment and the Functional Scheme assessment can help determine specific skills to prioritize for programming.

Occupational and physical therapy are very important to Active Learning. If a child is not or has difficulty moving learning will be limited in the earliest developmental stages. Likewise, vision loss impacts a child’s motivation to move so assessment by the teacher of students with visual impairments and an orientation and mobility specialist are critical. If the child is visually impaired, the TVI should be consulting with both the PT and OT as they assess fine and gross movements.

Communication is important to all children in learning. A thorough assessment of a child’s hearing is very important to the development of speech and language (spoken or sign language). Hearing is also important to help a child orient to the space around him, support the use of vision to identify people, objects and actions, and alert the child to important events occurring around him or her. A speech-language pathologist, teacher of the deaf and hard of hearing, and/or audiologist can utilize the Functional Scheme as part of their assessment process. For example, the sections on mouth movement, spatial perception, language (verbal and non-verbal) and language comprehension are especially useful. Because language development is impacted when a child has a visual impairment, a TVI should be consulting on communication assessments. If the child is trying to learn sign language, an OT and the TVI need to consult on the child’s ability to form signs as well as see the signs. If the child is hard of hearing or deaf and learning to speechread, the TVI and TDHH will need to work with each other to determine how well the child can use vision for speechreading.

Both the speech-language pathologist and occupational therapist may want to contribute to and/or utilize mouth movement, smell and taste, and eating skills sections of the Functional Scheme. These areas also relate to independent living skills areas of assessment that concern the teacher of students with visual impairments or deaf and hard of hearing for expanded core curriculum assessment.

Music therapy, dance and listening skills go hand-in-hand. Speaking of hands, use of haptic-tactile perception is important to playing instruments. Learning different pitches and rhythms, part of music, also relates to using these elements in speech.

What we are saying is that all development in the earliest stages is related. That is why detailed assessment using the Functional Scheme becomes so important for our sensorimotor learners and early pre-operational learners. No single person can adequately assess the child if they are only looking a one aspect (e.g. gross motor) without taking into consideration development in other areas (e.g., vision and hearing). Teams may want to review information on which sections of the Functional Scheme can be beneficial in their assessment and consider how to collaborate to complete this tool.

Direct Therapy and Active Learning Activities

Direct therapy of the sort provided frequently by occupational therapist, physical therapist, speech-language pathologists, teachers of students who are deaf and hard of hearing or visually impaired may be needed. Frequently these are done in 30-60 minute sessions one-on-one. These sessions frequently might involve hands on manipulation of the child’s body (e.g. to stretch a limb) or require work in a quiet environment (e.g. auditory training in preparation of a hearing test, speech reading or vocal training). This doesn’t mean that just because the therapist or related service provider works directly with the child that an Active Learning approach cannot be used during the session or to supplement the direct therapy throughout the day.

These children need lots of repetition of developing skills that occurs frequently throughout the day. They need encouragement and opportunities to complete movements on their own without being physically manipulated by an adult. Targeting skills that are the focus of therapies in the design of Active Learning activities can help the child make greater progress towards achieving these goals. The therapist or related service staff should help design activities and monitor progress on goals within these activities that related to their areas of expertise.

Review the IEP Goals and Benchmarks pages for ideas about how therapy goals can be worked on using an Active Learning approach.

Videos

The videos below show examples of how an Active Learning approach can be used to work on a variety of skills that can support various therapy goals. A well-designed learning activity will incorporate opportunities for the child to practice a variety of skills in a single environment or activity.

Oral Motor Skills and Speech

In this video we see a child playing with his music therapist as he rests on a drum. He is working on listening skills as well as vocalizing skills. He is strengthening muscles in his lungs, throat and mouth that are needed for speech. Notice how the therapist pauses and waits for him to take a turn before continuing to sing. This creates a clear signal for the child to take a turn, part of conversation.

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Speech and Auditory Skills

In this video we see a young boy playing with a metal bowl. He is practicing using his voice independently. He does not imitate the adult at this point, but does repeat sounds in rhythmical patterns.
 

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Feeding Skills

In this video the music therapist is working on feeding skills using a drum stick and chocolate pudding. Working on feeding skills in the context of play rather than during his regular meal time removes some of the stress for both the child and adult. Nutrition is not as important as his willingness to try different textures and bring the drumstick into his mouth.

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Gross Movement, Balance, and Spatial Orientation Skills

In this video we see a young girl working on developing leg and torso strength as well as balance using a Essef Board. She also incidentally is working on orienting herself relative to the wall, the Essef Board and the basket of balls.

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Visual Skills, Reach and Grasp

In this video we see a toddler playing with red Mardi Gras beads suspended above a light box. He has cerebral/cortical visual impairment and is working on developing a visually directed reach. He is also learning to grasp and let go of the beads, a goal related to fine motor.
 
 
 
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We encourage you to explore other videos on the website, especially under Cognitive Skills and Implementation to see how a single activity can be used to give the child many opportunities to work on a variety of skills all day long.