Orientation and Mobility Services

We’re getting there! Almost through with the O’s!

Orientation and mobility services (O&M) became part of IDEA’s list of related services with IDEA ’97. They are defined at §300.34(c)(7) and even a brief read makes it clear that O&M services are intended for children who are blind or visually impaired, with the purpose of teaching them how to orient themselves in a range of environments (school, home, community) and to move safely within those environments.

(7) Orientation and mobility services—

(i) Means services provided to blind or visually impaired children by qualified personnel to enable those students to attain systematic orientation to and safe movement within their environments in school, home, and community; and

(ii) Includes teaching children the following, as appropriate:

(A) Spatial and environmental concepts and use of information received by the senses (such as sound, temperature and vibrations) to establish, maintain, or regain orientation and line of travel (e.g., using sound at a traffic light to cross the street);

(B) To use the long cane or a service animal to supplement visual travel skills or as a tool for safely negotiating the environment for children with no available travel vision;

(D) Other concepts, techniques, and tools. [§300.34(c)(7)]

O&M services are not intended for children with disabilities other than visual impairments. If such a child needs to learn how to safely navigate a variety of settings, that child would generally not receive O&M services but, rather, travel training. Travel training is included in the definition of special education and means providing instruction to children with significant cognitive disabilities, and any other children with disabilities who require this instruction, to enable them to develop an awareness of the environment in which they live and learn the skills necessary to move effectively and safely from place to place [§300.39(b)(4)].

Parent Counseling and Training

Parent counseling and training is an important related service that can help parents enhance the vital role they play in the lives of their children. Its definition is found at §300.34(c)(8) and reads:

(8)(i) Parent counseling and training means assisting parents in understanding the special needs of their child;

(ii) Providing parents with information about child development; and

(iii) Helping parents to acquire the necessary skills that will allow them to support the implementation of their child’s IEP or IFSP.

The first two parts of this definition are longstanding in IDEA. The last part—regarding helping parents acquire the necessary skills that will allow them to support the implementation of their child’s IEP or IFSP—was added in IDEA ’97 “to recognize the more active role of parents as participants in the education of their children” (71 Fed. Reg. at 46573) and is retained in IDEA 2004. As with all related services, parent counseling and training would only be provided to parents “if a child’s IEP team determines that it is necessary for the child to receive FAPE” (Id.).

Physical Therapy

IDEA defines physical therapy as “services provided by a qualified physical therapist” [§300.34(c)(9)]. These services generally address a child’s posture, muscle strength, mobility, and organization of movement in educational environments. Physical therapy may be provided to prevent the onset or progression of impairment, functional limitation, disability, or changes in physical function or health resulting from injury, disease, or other causes.

Psychological Services

Now here comes a longish definition! IDEA defines psychological services at §300.34(c)(10) as follows:

(10) Psychological services includes—

(i) Administering psychological and educational tests, and other assessment procedures;

(ii) Interpreting assessment results;

(iii) Obtaining, integrating, and interpreting information about child behavior and conditions relating to learning;

(iv) Consulting with other staff members in planning school programs to meet the special educational needs of children as indicated by psychological tests, interviews, direct observation, and behavioral evaluations;

(v) Planning and managing a program of psychological services, including psychological counseling for children and parents; and

(vi) Assisting in developing positive behavioral intervention strategies.

Psychological services are delivered as a related service when necessary to help eligible children with disabilities benefit from their special education. In some schools, these services are provided by a school psychologist, but some services are also appropriately provided by other trained personnel, including school social workers and counselors.

You may notice that counseling is mentioned in the definition of this related service, and is also mentioned in IDEA’s definition of social work services (specifically, group and individual counseling with the child and family). In response to public comments questioning this, the Department clarified:

Including counseling in the definition of social work services in schools in §300.34(c)(14) is intended to indicate the types of personnel who assist in this activity and is not intended either to imply that school social workers are automatically qualified to perform counseling or to prohibit other qualified personnel from providing counseling, consistent with State requirements. (71 Fed. Reg. at 46573-4]

Further, the definition of psychological services uses the phrase “planning and managing a program of psychological services”—which includes “psychological counseling for children and parents.” The more administrative nature of “planning and managing” is a telling difference in how counseling is included in the definitions of these two related services.

IDEA’s definition of psychological services also specifically mentions positive behavioral intervention strategies, often referred to as PBS or PBIS. Behavior is an area of great concern these days, and it’s useful to know that many of IDEA’s provisions support taking a proactive approach to addressing behavior that interferes with a child’s learning or the learning of others. For such a child, the IEP team must consider, if appropriate, strategies (including positive behavioral interventions, strategies, and supports) to address that behavior [§300.324(2)(i)].

The fact that psychological services can include “assisting in developing positive behavioral intervention strategies” does not mean that only the professionals who provide psychological services may provide such assistance or that they are even necessarily qualified to do so. As the Department states:

There are many professionals who might also play a role in developing and delivering positive behavioral intervention strategies. The standards for personnel who assist in developing and delivering positive behavioral intervention strategies will vary depending on the requirements of the State. Including the development and delivery of positive behavioral intervention strategies in the definition of psychological services is not intended to imply that school psychologists are automatically qualified to perform these duties or to prohibit other qualified personnel from providing these services, consistent with State requirements. (71 Fed. Reg. at 46574)

Recreation

We’re to the R’s, making slow but sure progress through IDEA’s list of related services. Recreation as a related service is defined at §300.34(c)(11) and reads:

(11) Recreation includes—

(i) Assessment of leisure function;

(ii) Therapeutic recreation services;

(iii) Recreation programs in schools and community agencies; and

(iv) Leisure education.

Recreation services generally are intended to help children with disabilities learn how to use their leisure and recreation time constructively. Through these services, children can learn appropriate and functional recreation and leisure skills. Recreational activities may be provided during the school day or in after-school programs in a school or a community environment. Some school districts have made collaborative arrangements with the local parks and recreation programs or local youth development programs to provide recreational services.

As part of providing this related service, persons qualified to provide recreation carry out activities such as:

assessing a child’s leisure interests and preferences, capacities, functions, skills, and needs;
providing recreation therapeutic services and activities to develop a child’s functional skills;
providing education in the skills, knowledge, and attitudes related to leisure involvement;
helping a child participate in recreation with assistance and/or adapted recreation equipment;
providing training to parents and educators about the role of recreation in enhancing educational outcomes;
identifying recreation resources and facilities in the community; and
providing recreation programs in schools and community agencies. (Mattson, 2001)

Rehabilitation Counseling

And here is another related service that specifically mentions counseling. Rehabilitation counseling, however, uses such key terms as employment, career, and independence, which narrows the focus of the counseling and the purpose for which it is provided. The definition reads:

(12) Rehabilitation counseling services means services provided by qualified personnel in individual or group sessions that focus specifically on career development, employment preparation, achieving independence, and integration in the workplace and community of a student with a disability. The term also includes vocational rehabilitation services provided to a student with a disability by vocational rehabilitation programs funded under the Rehabilitation Act of 1973, as amended, 29 U.S.C. 701 et seq. [§300.34(c)(12)]

Wondering about the reference to vocational rehabilitation (VR)? VR is a nationwide federal-state program for assisting eligible people with disabilities to define a suitable employment goal and become employed. Each state has a central VR agency, and there are local offices in most states. VR provides medical, therapeutic, counseling, education, training, and other services needed to prepare people with disabilities for work. VR is an excellent place for a youth or adult with a disability to begin exploring available training and support service options. For more information on VR programs funded under the Rehabilitation Act of 1973:

To find your state’s VR system and connect with eligibility and services information.
Consult NICHCY’s State Resource Sheet for your state. You’ll find the state’s VR agency listed under the main category of “State Agencies,” and then beneath the heading of “State Vocational Rehabilitation Agency.” Our State Resource Sheets are available online at: http://www.nichcy.org/state-organization-search-by-state

Visit TATRA, Technical Assistance on Transition and the Rehabilitation Act.
Scan down the page at the link below, until you come to State Vocational Rehabilitation Programs. That’s where you can easily identify where to contact your state’s VR agency.
http://www.pacer.org/tatra/resources/vr.asp

School Health Services and School Nurse Services

School health services have long been a part of IDEA’s related services definition. In IDEA 2004, the term has been changed to school health services and school nurse services, with the following definition at §300.34(c)(13):

(13) School health services and school nurse services means health services that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP. School nurse services are services provided by a qualified school nurse. School health services are services that may be provided by either a qualified school nurse or other qualified person.

Returning to an issue that was raised under Medical Services, many children with disabilities, especially those who are medically fragile, could not attend school without the supportive services of school nurses and other qualified people. Over the years, the extent of the health-related services that are provided in schools has grown, as might be expected when you consider medical advances in the last decade alone. In Cedar Rapids Community School District v. Garret F., the question of whether or not public agencies are responsible for providing health-related supports that are complex or continuous was settled. They are, “only to the extent that the services allow a child to benefit from special education and enable a child with a disability to receive FAPE” (71 Fed. Reg. at 46574-5). What was previously called “school health services” in IDEA has been expanded to distinguish between services that are provided by a qualified nurse and those that may be provided by other qualified individuals.

States and local school districts often have guidelines that address school health services and school nurse services. These may include providing such health-related support as:

special feedings;
clean intermittent catheterization;
suctioning;
the management of a tracheostomy;
administering and/or dispensing medications;
planning for the safety of a child in school;
ensuring that care is given while at school and at school functions to prevent injury (e.g., changing a child’s position frequently to prevent pressure sores);
chronic disease management; and
conducting and/or promoting education and skills training for all (including the child) who serve as caregivers in the school setting. (U.S. Department of Education, 2003)

Social Work Services in Schools

Issues or problems at home or in the community can adversely affect a child’s performance at school, as can a child’s attitude or behavior in school. Social work services in schools may become necessary in order to help a child benefit from his or her educational program. They are also a familiar related service, included in IDEA from its early days, and are currently defined at §300.34(c)(14) as follows:

(14) Social work services in schools includes—

(i) Preparing a social or developmental history on a child with a disability;

(ii) Group and individual counseling with the child and family;

(iii) Working in partnership with parents and others on those problems in a child’s living situation (home, school, and community) that affect the child’s adjustment in school;

(iv) Mobilizing school and community resources to enable the child to learn as effectively as possible in his or her educational program; and

(v) Assisting in developing positive behavioral intervention strategies. [§300.34(c)(14)]

Speech-Language Pathology

Speech-language pathology services are provided by speech-language professionals and speech-language assistants, in accordance with state regulations, to address the needs of children and youth with disabilities affecting either speech or language. IDEA defines this related service at §300.34(c)(15) as:

(15) Speech-language pathology servicesincludes—

(i) Identification of children with speech or language impairments;

(ii) Diagnosis and appraisal of specific speech or language impairments;

(iii) Referral for medical or other professional attention necessary for the habilitation of speech or language impairments;

(iv) Provision of speech and language services for the habilitation or prevention of communicative impairments; and

(v) Counseling and guidance of parents, children, and teachers regarding speech and language impairments.

Speech-language pathology services are longstanding related services in IDEA. They are also crucial in the education of many children with disabilities. More than 1 million children are served under the disability category of “speech or language impairments” alone, according to the 25th Annual Report to Congress (U.S. Department of Education, 2003).

Transportation

Transportation is included in an eligible child’s IEP if the IEP team determines that such a service is needed in order for the child to benefit from his or her special education. The term has a specific meaning. IDEA definestransportation as:

travel to and from school and between schools;
travel in and around school buildings; and
specialized equipment (such as special or adapted buses, lifts, and ramps), if required to provide special transportation for a child with a disability. [§300.34(c)(17)]

The last bullet isn’t just talking about a separate bus that only children with disabilities ride to school. The Department of Education states, “It is assumed that most children with disabilities will receive the same transportation provided to nondisabled children” (Id.), in keeping with LRE requirements. Thus, transportation as a related services may also mean providing modifications and supports so that a child may ride the regular school bus transporting children without disabilities. (71 Fed. Reg. at 46576).

As part of longstanding OSEP policy and numerous written policy letters, memos, and summaries, public school districts must provide transportation to children with disabilities in two situations. These are:

if a district provides transportation to and from school for the general student population, then it must provide transportation for a child with a disability; and
if a school district does not provide transportation for the general student population, then the issue of transportation for children with disabilities must be decided on a case-by-case basis if the IEP Team has determined that transportation is needed by the child and has included it on his or her IEP.

Not all children with disabilities are eligible to receive transportation as a related service. A child’s need for transportation as a related service and the type of transportation to be provided must be discussed and decided by the IEP team. If the team determines that the child needs this related service to benefit from her or her special education, a statement to that effect must be included in the IEP, along with relevant details and arrangements.

In Conclusion

That was quite a list, wasn’t it? You no doubt now have a very good sense of how extensive, well-thought-out, and important related services actually are for children with disabilities who need them. It’s no wonder the term so often appears with its buddy, special education.

References

American School Counselor Association. (2007). Role of the school counselor. Retrieved September 9, 2010 at http://www.schoolcounselor.org/content.asp?pl=327&sl=341&contentid=341

Cedar Rapids Community School District v. Garrett F, 526 U.S. 66 (1999). Available online at: www.wrightslaw.com/law/caselaw/case_Cedar_Rapids_SupCt_990303.htm

Mattson, B. (2001). Related services (2nd ed.). NICHCY News Digest 16, 1-20.

National Institute on Deafness and Other Communication Disorders. (2006a). Cochlear implants (NIH Publication No. 00-4798). Bethesda, MD: Author. Available online at: http://www.nidcd.nih.gov/health/hearing/coch.asp

National Institute on Deafness and Other Communication Disorders. (2006b). Statistics about hearing disorders, ear infections, and deafness. Bethesda, MD: Author. Available online at: http://www.nidcd.nih.gov/health/statistics/pages/hearing.aspx

Supreme Court adopts bright-line test in medical services case. (1999, March 12). The Special Educator, 14(15), 1, 6-7.

U.S. Department of Education (2003). Annual report to Congress on the implementation of the Individuals with Disabilities Education Act, Vol. 2. Washington, DC: Author. Available online at: http://www.ed.gov/about/reports/annual/osep/index.html

U.S. Department of Education. (2006). 26th annual report to Congress on the implementation of IDEA: Vol. 2. Washington, DC: Author. Available online at: http://www.ed.gov/about/reports/annual/osep/2004/index.html

Would you like to read about another component of the IEP?

If so, use the links below to jump there quickly.
_________________________________________________

Present Levels
How is the child currently doing in school? How does the disability affect his or her performance in class? This type of information is captured in the “present levels” statement in the IEP.

Annual Goals
Once a child’s needs are identified, the IEP team works to develop appropriate goals to address those needs. Annual goal describe what the child is expected to do or learn within a 12-month period.

Benchmarks or Short-Term Objectives
Benchmarks or short-term objectives are required only for children with disabilities who take alternate assessments aligned to alternate achievement standards. If you’re wondering what that means, this article will tell you!

Measuring and Reporting Progress
Each child’s IEP must also contain a description of how his or her progress toward meeting the annual goals will be measured and when it will be reported to parents. Learn more about how to write this statement in this short article.

Special Education
The IEP must contain a statement of the special education and related services and supplementary aids and services to be provided to the child, or on behalf of the child. This article focuses on the first element: a statement of the special education that will be provided for the child.

Related Services (you’re already here!)
To help a child with a disability benefit from special education, he or she may also need extra help in one area or another, such as speaking or moving. This additional help is called related services. Find out all about these critical services here.

Supplementary Aids and Services
Supplementary aids and services are intended to improve children’s access to learning and their participation across the spectrum of academic, extracurricular, and nonacademic activities and settings. The IEP team must determine what supplementary aids and services a child will need and specify them in the IEP.

Program Modifications for School Personnel
Also part of the IEP is identifying the program modifications or supports for school personnel that will be provided. Read more here.

Extent of Nonparticipation
The IEP must also include an explanation of the extent, if any, to which the child will not participate with nondisabled children in the regular class and in other school settings and activities. Read how this connects to IDEA’s foundational principle of LRE.

Accommodations in Assessment
IDEA requires that students with disabilities take part in state or districtwide assessments. The IEP team must decide if the student needs accommodations in testing or another type of assessment entirely. In this component of the IEP, the team documents how the student will participate.

Service Delivery
When will the child begin to receive services? Where? How often? How long will a “session” last? Pesky details, but important to include in the IEP!

Transition Planning
Beginning no later than a student’s 16th birthday (and younger, if appropriate), the IEP must contain transition-related plans designed to help the student prepare for life after secondary school.

Age of Majority
Beginning at least one year before the student reaches the age of majority, the IEP must include a statement that the student has been told about the rights (if any) that will transfer to him or her at age of majority. What is “age of majority” and what does this statement in the IEP look like?

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Issue #7: Related Services for Children with Severe Disabilities Part II