Table of Contents
- Determining What Related Services a Student Needs
- What is excluded as a Related Service?
- Counseling services
- Early ID of disabilities
- Interpreting services
- Medical services
- Occupational therapy
- Orientation and mobility
- Parent counseling and training
- School health services & school nurse services
- Social work services in schools
- Speech-language pathology
- Physical therapy
- Psychological services
- Rehabilitation counseling
- Voices from the Field
Adapted from: Center for Parent Information and Resources (6.25.2020). Related Services, Newark, NJ, Author (2017). and Center for Parent Information & Resources, (2017). Specifying Related Services in the IEP.
Related services help children with disabilities benefit from their special education by providing extra help and support in needed areas, such as speaking or moving.
IDEA’s Exact Words
Let’s start with IDEA’s full requirement for specifying a child’s related services in his or her IEP. This appears at §300.320(a)(4) and stipulates that each child’s IEP must contain:
(4) A statement of the special education and related services and supplementary aids and services, based on peer-reviewed research to the extent practicable, to be provided to the child, or on behalf of the child, and a statement of the program modifications or supports for school personnel that will be provided to enable the child—
(i) To advance appropriately toward attaining the annual goals;
(ii) To be involved in and make progress in the general education curriculum in accordance with paragraph (a)(1) of this section, and to participate in extracurricular and other nonacademic activities; and
(iii) To be educated and participate with other children with disabilities and nondisabled children in the activities described in this section… [§300.320(a)(4)]
We’ve bolded the part of IDEA’s regulation that specifically mentions related services, because it’s important to see the context in which this term is used. It is that context, and IDEA’s own definition of related services, that will guide how a child’s IEP team considers what related services the child needs and the detail with which the team specifies them in the IEP.
Beginning with Evaluation
IDEA requires that a child be assessed in all areas related to his or her suspected disability. This evaluation must be sufficiently comprehensive so as to identify all of the child’s special education and related services needs, whether or not those needs are commonly linked to the disability category in which he or she has been classified.
Determining What Related Services a Student Needs
It is the IEP team’s responsibility to review all of the evaluation information, to identify any related services the child needs, and to include them in the IEP. Goals can be written for a related service just as they are for other special education services.
Each child with a disability may not require all of the related services listed above. Furthermore, the list of related services is not exhaustive and may include other developmental, corrective, or supportive services if they are required to assist a child with a disability to benefit from special education. Examples include artistic and cultural programs, art, music, and dance therapy.
The IEP is a written commitment for the delivery of services to meet a student’s educational needs. A school district must ensure that all of the related services specified in the IEP, including the amount, are provided to a student.
Changes in the amount of services listed in the IEP cannot be made without holding another IEP meeting. However, if there is no change in the overall amount of service, some adjustments in the scheduling of services may be possible without the necessity of another IEP meeting.
Related Services Personnel on the IEP Team
IDEA does not expressly require that the IEP team include related services personnel. However, if a particular related service is going to be discussed in an IEP meeting, it would be appropriate for such personnel to be included or otherwise involved in developing the IEP. IDEA states that, at the discretion of the parent or the public agency, “other individuals who have knowledge or special expertise regarding the child, including related services personnel as appropriate” may be part of a child’s IEP team.
Do Parents Have to Pay for the Related Services Their Child Receives?
No. School districts may not charge parents of eligible students with disabilities for the costs of related services that have been included on the child’s IEP. Just as special and regular education must be provided to an eligible student with a disability at no cost to the parent or guardian, so, too, must related services when the IEP team has determined that such services are required in order for the child to benefit from his or her education.
Related Services, in Detail
To add detail to the “short story” above, let’s begin with the very first part of IDEA’s definition of related services at §300.34.
§300.34 Related services.
(a) General. Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education, and includes…
This beginning represents the core of how IDEA defines related services. The term related services is typically spoken in the same breath as special education (similar to how “peas and carrots” and “ham and eggs” go together) and, when used in IDEA, will always have the same meaning, including the part of the definition we haven’t shown you yet, which picks up where the beginning leaves off…
…and includes speech-language pathology and audiology services, interpreting services, psychological services, physical and occupational therapy, recreation, including therapeutic recreation, early identification and assessment of disabilities in children, counseling services, including rehabilitation counseling, orientation and mobility services, and medical services for diagnostic or evaluation purposes. Related services also include school health services and school nurse services, social work services in schools, and parent counseling and training.
Clearly, the list of related services is long–and, as already mentioned, the list is not exhaustive. These are just the services that IDEA specifically mentions. As states respond to the requirements of federal law, many have legislated their own related service requirements, which may include services beyond those specified in IDEA.
What’s Excluded as a Related Service?
IDEA makes a specific exception to the list of related services: surgically implanted devices, including cochlear implants.
This exception is new with IDEA 2004 and shows the advance of time and technology. A relatively new technological development, the cochlear implant is a “small, complex electronic device that can help to provide a sense of sound to a person who is profoundly deaf or severely hard-of-hearing.” (National Institute on Deafness and Other Communication Disorders, 2017). While an implant does not restore normal hearing, it can give the recipient “a useful representation of sounds in the environment and help him or her to understand speech” (Id.).
Cochlear implants are not the only surgically implanted devices. Others include: insulin pump, baclofen pump, pacemaker, G-tube, and vagus nerve stimulator device.
The exception. If a child has a surgically implanted device, the scope of the public agency’s responsibility to provide supportive related services in relation to that device is covered in IDEA’s provisions at §300.34(b), its exception. Public agencies are not responsible for optimizing these devices, maintaining them, or replacing them. Public agencies are responsible for “routine checking to determine if the external component of a surgically implanted device is turned on and working” (71 Fed. Reg. 46570) and for providing other types of services the child needs, as determined by the IEP team, including:
- Assistive technology (e.g., FM system);
- Proper classroom acoustical modifications;
- Educational support services (e.g., educational interpreters); and
- Receiving the related services (e.g., speech and language services) that are necessary for the child to benefit from special education services. (Id.)
While public agencies are not responsible for mapping a cochlear implant, they do have a role to play in providing services and supports to help children with cochlear implants. As the Department observes:
Particularly with younger children or children who have recently obtained implants, teachers and related services personnel frequently are the first to notice changes in the child’s perception of sounds that the child may be missing. This may manifest as a lack of attention or understanding on the part of the child or frustration in communicating. The changes may indicate a need for remapping, and we would expect that school personnel would communicate with the child’s parents about these issues. To the extent that adjustments to the devices are required, a specially trained professional would provide the remapping, which is not considered the responsibility of the public agency. (71 Fed. Reg. at 46570-1)
In many ways, the Department points out, there is no substantive difference between serving a child with a cochlear implant in a school setting and serving a child with a hearing aid. A “public agency is responsible for the routine checking of the external components of a surgically implanted device in much the same manner as a public agency is responsible for the proper functioning of hearing aids” (71 Fed. Reg. at 46571). What distinguishes a service covered under the Act and one that is excluded is, in large measure, “the level of expertise required” (Id.). Maintaining and monitoring a surgically implanted device require the expertise of a licensed physician or an individual with specialized technical expertise beyond that typically available from school personnel. On the other hand:
Teachers and related service providers can be taught to first check the externally worn speech processor to make sure it is turned on, the volume and sensitivity settings are correct, and the cable is connected, in much the same manner as they are taught to make sure a hearing aid is properly functioning. To allow a child to sit in a classroom when the child’s hearing aid or cochlear implant is not functioning is to effectively exclude the child from receiving an appropriate education. (Id.)
You’ll note that the exception in IDEA is carefully crafted to ensure that public agencies remain aware of, and responsible for, monitoring and maintaining “medical devices that are needed to maintain the health and safety of the child, including breathing, nutrition, or operation of other bodily functions, while the child is transported to and from school or is at school” (§300.34(b)(2)(ii)]. This clearly aligns with a public agency’s responsibility for the health-related services (see discussion of Medical Services and School Health Services and School Nurse Services further below).
The definition of audiology as a related service appears at §300.34(c)(1) and reads:
(1) Audiology includes—
(i) Identification of children with hearing loss;
(ii) Determination of the range, nature, and degree of hearing loss, including referral for medical or other professional attention for the habilitation of hearing;
(iii) Provision of habilitative activities, such as language habilitation, auditory training, speech reading (lip-reading), hearing evaluation, and speech conservation;
(iv) Creation and administration of programs for prevention of hearing loss;
(v) Counseling and guidance of children, parents, and teachers regarding hearing loss; and
(vi) Determination of children’s needs for group and individual amplification, selecting and fitting an appropriate aid, and evaluating the effectiveness of amplification. [§300.34(c)(1)]
Audiology is primarily provided to support the needs of children with hearing loss and includes (but is not limited to) key services such as determining the range, nature, and degree of a child’s hearing loss and both group and individual needs for amplification. More than 77,000 children, ages 3-21, were served in the U.S. in 2013-2014 under IDEA’s category of hearing impairments (U.S. Department of Education, 2016).
The National Institute on Deafness and Other Communication Disorders (2016) estimates that about 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears. Because it’s so important to identify and address childhood hearing loss as early as possible, universal newborn hearing screening programs currently operate in all U.S. states and most U.S. territories (National Institute on Deafness and Other Communication Disorders, 2017). With help from the federal government, every state has established an Early Hearing Detection and Intervention program. Find your state’s contact for this program at: http://infanthearing.org/status/cnhs.php
Some schools have hearing screening programs and staff trained to conduct audiology screenings of children. Others may participate in regional cooperatives or other arrangements that provide audiology services. Those school districts that do not have diagnostic facilities to evaluate children for hearing loss and related communication problems or central auditory processing disorders may refer children to a clinical setting, such as a hospital or audiology clinic, or make other contractual arrangements.
IDEA defines counseling services as follows:
(2) Counseling services means services provided by qualified social workers, psychologists, guidance counselors, or other qualified personnel. [§300.34(c)(2)]
According to the American School Counselor Association (n.d.), counseling services are intended to help all children in the areas of academic achievement, personal/social development and career development. This can include helping children with personal and social concerns such as developing self-knowledge, making effective decisions, learning health choices, and improving responsibility. Counselors may also help children with future planning related to setting and reaching academic goals, developing a positive attitude toward learning, and recognizing and utilizing academic strengths.
Note that IDEA’s list of related services includes other counseling services—parent counseling and training; and rehabilitation counseling (that is, counseling specific to career development and employment preparation). These are defined separately in IDEA and are clearly different from counseling services (which are also not to be confused with psychological services).
Early Identification and Assessment of Disabilities in Children
This related service is defined at §300.34(c)(3) as follows:
(3) Early identification and assessment of disabilities in children means the implementation of a formal plan for identifying a disability as early as possible in a child’s life.
The disability and medical fields are full of information about early identification of disabilities in children as well as assessing the scope and impact of a child’s disability. This literature is focused on system-level issues such as setting up screening programs for specific disabilities (e.g., autism, speech-language impairment, visual and hearing impairments) and establishing mechanisms within the educational system by which children at risk of learning problems are quickly identified and their learning issues addressed.
As a related service, however, early identification and assessment of disability in children represents an individual service for one child. If a child’s IEP team determines that identifying and assessing the nature of a child’s disability is necessary in order for the child to benefit from his or her special education, then this related service must be listed in the child’s IEP and provided to the child by the public agency at no cost to the parents. A formal plan would be written to establish the process and procedures by which the child’s disability will be identified.
This may seem strange—identifying the disability? Isn’t that one of the purposes of evaluation? True. But disability can elude diagnosis, even as it adversely affects academic and functional performance in clear and measurable ways. Permitting states to adopt the term “developmental delay” acknowledges that it’s not always possible to say what’s causing a learning or other problem, but that intervention is still necessary. Early identification and assessment of disability in children, as a related service, acknowledges that continuing to search for and identify the disability as early as possible in a child’s life may be necessary if the child is going to derive benefit from special education.
Interpreting services were added to IDEA’s list of related services in the 2004 reauthorization and are defined at §300.34(c)(4) as follows:
(4) Interpreting services includes—
(i) The following, when used with respect to children who are deaf or hard of hearing: Oral transliteration services, cued language transliteration services, sign language transliteration and interpreting services, and transcription services, such as communication access real-time translation (CART), C-Print, and TypeWell; and
(ii) Special interpreting services for children who are deaf-blind. [§300.34(c)(4)]
Interpreting services may be new to IDEA’s definition of related services, but they are been provided over the years to many children who are deaf or hard of hearing, as part of providing them with access to instruction. The definition of interpreting services indicates a range of possible such services (e.g., oral transliteration, cued language), all of which refer to specific communication systems used within the deaf and hard-of-hearing community.
Medical services are considered a related service only under specific conditions: when they are provided (a) by a licensed physician, and (b) for diagnostic or evaluation purposes only. This is clear from the definition at §300.34(c)(5):
(5) Medical services means services provided by a licensed physician to determine a child’s medically related disability that results in the child’s need for special education and related services.
This related service has a long and interesting history that has only gotten more interesting as medical science has advanced and children with diverse medical conditions are being educated in increasing numbers in general education classrooms. The support that many such children need in order to attend school, school districts have argued, is medical in nature, complex and continual, and is not the responsibility of public agencies because IDEA clearly states that medical services are allowable related services only when provided for diagnostic or evaluation purposes.
The case of Cedar Rapids Community School District v. Garret F., which took place in 1999, turned the gray line about the provision of related services to children with complex medical needs into a “bright line” (“Supreme Court adopts,” 1999). The U.S. Supreme Court found that, if a related service is required to enable a qualified child with a disability to remain in school, it must be provided as long as it is not a purely “medical” service. What is considered “medical,” as IDEA’s definition amply indicates, are those services that can only be provided by a licensed physician (and only for the purposes of diagnosis or evaluation). If a non-physician can deliver the services, then the service must be provided by public agencies, regardless of the staffing or fiscal burdens they may impose. Health care services that can be provided by a non-physician are not provided under the category of medical services, however. Today they would be as considered school health services and school nurse services. Examples of such services include bladder catheterization, tracheostomy tube suctioning, positioning, and monitoring of ventilator settings, to name a few.
The term occupational therapy (OT) is defined in IDEA at §300.34(c)(6) as follows:
(6) Occupational therapy—
(i) Means services provided by a qualified occupational therapist; and
(A) Improving, developing, or restoring functions impaired or lost through illness, injury, or deprivation;
(B) Improving ability to perform tasks for independent functioning if functions are impaired or lost; and
(C) Preventing, through early intervention, initial or further impairment or loss of function.
OT services can enhance a child’s ability to function in an educational program and may include such services as:
- self-help skills or adaptive living (e.g., eating, dressing);
- functional mobility (e.g., moving safely through school);
- positioning (e.g., sitting appropriately in class);
- sensory-motor processing (e.g., using the senses and muscles);
- fine motor (e.g., writing, cutting) and gross motor performance (e.g., walking, athletic skills);
- life skills training/vocational skills; and
- psychosocial adaptation.
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;
(C) To understand and use remaining vision and distance low vision aids; and
(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.).
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.
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)
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;
- Improving physical functioning, including using activities to develop locomotor skills, balance, coordination, motor planning, strength and endurance, object control skills, and eye/hand coordination;
- Improving cognitive functioning with therapeutic activities that improve attention span, problem solving, decision making skills, and creative expression;
- Improving behavioral functioning with therapeutic activities that improve anger/frustration control, respect for others and self, trust issues, stress management, relaxation training, and team building skills; and
- Providing instruction in leisure education to develop the skills necessary for independence in recreational participation. (American Therapeutic Recreation Association, n.d.)
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, and where the central VR office is located in your state, visit the Job Accommodation Network, at: https://askjan.org/
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;
- 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.
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 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 services includes—
(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 1.3 million children were served under the disability category of “speech or language impairments” in the school year 2013-14 (U.S. Department of Education, 2016).
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 defines transportation 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.
Reflect on how can the special educator develop a collaborative relationship with related service providers that will help ensure that the related services are integrated into the students’ educational program.
Voices from the Field
When a child is deaf or hard of hearing, the IEP team needs to consider the child’s language and communication needs, and whether the child needs assistive technology devices and services [34 C.F.R.§300.324(a)(2)(iv-v)]. We may find this very challenging if hearing is not one of our areas of expertise. That is why we need to collaborate with the related services – educational audiologist – in order to ensure that our student is able to access the curriculum.
Some ideas for special educators working in collaboration with audiologists for students are for the whole team to meet and share their observations and questions and ideas to work together toward solutions that are helpful to the student, and for the educational audiologist to train the child’s whole team on the best utilization of the assistive technology being used for the child. The educational audiologist has in-depth specialized knowledge that classroom teachers may not even be aware of, so it can be very helpful to collaborate fully. For example, the educational audiologist will be aware of current auditory and visual classroom technologies and remote instructional accommodations that are not known to regular classroom teachers. Michaela Donati
An audiologist is a professional that diagnoses and treats individuals who have hearing impairments and balance difficulties. A school audiologist helps individuals who have hearing loss or an auditory processing disorder to help them access the curriculum. They are trained in an assortment of tasks like fitting and maintaining technology (FM systems), teaching/ guiding families, supporting staff and teachers, as well as consultation. They also attend IEP meetings and can diagnose or assess hearing loss or auditory processing disorders as well as looking into children’s functional performance within the classroom. School audiologists can also help with troubleshooting or fixing minor hearing aid repairs, give hearing screenings and test the classroom for acoustics for individuals who have hearing disorders. Asheigh Stone
Early Interventions and Assessment of Disabilities
I worked in an inclusive preschool in our public school before moving to full time at the k-5 level. I was always amazed by the amount of progress preschool aged kids can make in a short period of time. Early interventions can do so much good. Our school does “child finds” a few times a year where parents can bring their preschool aged kiddo in to be screened by our preschool teachers, SLP and OT to see if they could benefit from early interventions, if there’s any concerns etc. anonymous
Our OT at school is one of my favorite people! Her suggestions are always so helpful and I have learned so much from her. She helps us with everything from toilet training and self-dressing strategies to teaching the kids how to tie shoes. She also started a school store that she runs with our students, they all have jobs and it helps with so many things from math to social skills. Anonymous
Last year, I had a student who was working with an occupational therapist at school with typing. At the beginning of the year, they really struggled with this. Going into remote learning, I was nervous, but the skills he was learning and practicing really showed! The consistent practice and the occupational therapist’s guidance really helped this student grow immensely with their typing. Anonymous
One student I work with now, for example, really struggles with fine motor skills. The OT, case manager, and I have met, and the OT suggested strategies to use – for writing, propping up his notebook on a slanted binder and utilizing paper with much larger width between lines, among other things. Plus incorporating practice tying his shoes into his regular routine. Because we are all working together, the student will realize the most benefits and success. Anonymous.
The OT might ask you the teacher or paraeducator to perform a daily task that will help a student learn a basic skill. My 1:1 student (and many other students at the school) have to use a thinking putty once a day. This is about a 5 minute or less activity that forces the student to use the muscles in their hands to increase their fine motor skills. The student has a laminated worksheet that tells them the shapes to make in the putty in a numbered sequence. Such as roll putty into a ball, roll putty into a snake, punch putty snake 10 times. These exercises help strengthen the muscles in their hands while also giving the student a mental break to focus on a calming activity. I’ve also seen students practice tying shoes with a simulated board with shoe laces attached to it. This helps with motor skills as well as teaching them a life skill. I also keep data on my students.This data goes directly to my occupational therapist. It keeps track of how the student self manages their “heightened states” if they ask for breaks, or if I prompt “do you need a break”. It also tracks If they’re using the self regulation skills that they are taught in OT, or the tools they are given; putty, fidgets, asking for breaks and walks. This keeps open communication between myself (who works with the student all day) and the occupational therapist who sees them once a week. Jazmine Perkins
Orientation and Mobility (O&M) Specialist
It wasn’t until about 15 years into working in the field of special ed that I made my first encounter with an Orientation and Mobility (O&M) Specialist. We had a student who was blind and reading braille come through our public school! Working with her was great and she really helped in training us on how to better help and work with someone visually impaired. Simple things like introducing yourself every time you approach the person, keeping furniture stable, and how to promote independence were valuable snippets of information that seems so reasonably apparent in hindsight but was great to spell out to us. Kari Grimes
I have seen a vision specialist work with a student with autism and a visual impairment. I saw her have familiar staff members located at various distances around the hallway to see how close he needs to be in order to recognize them. He also has custom signs throughout the hallway to help him navigate between 3 rooms (4th grade class, special ed room, and OT) more independently. The student can follow the big blue circles to class, the big red squares to his special education resource room, and the big orange triangles to get to OT. Anonymous
Parent Counseling and Training
As an in home behavior therapist one of my jobs is parent teaching. It is also something that my BCBA meets with the family twice a month for. We work on helping them learn and practice structured routines that help make the kiddos day go more smoothly (i.e. morning and night routines, chores and haircutting). We also work on community outings to help them predict and regulate behaviors that could occur while they are out in the community. Parents play a key role in students lives and when a child is diagnosed with a disability they are easily overwhelmed. Having someone help them through the process and reassure them that they are doing the right thing can reduce the stress that they face. Nicole Coonrod
I have recently referred a family to a local agency called Children Unlimited for counseling and parenting support as they have been experiencing some behavioral issues with their child at home and requested help for him. This agency will work with both the child and the family to create and implement strategies for the family to use in the home and community to manage disruptive behaviors.
I also work with a student with ASD who receives support from a BCBA and ABA (Applied Behavior Analysis) Therapist. In addition to providing support for the child, the Therapist also works with the family to model and teach techniques to better support their child. As a former ABA Therapist, I can attest that working with the parents is just as important as working with their child.
As the Family Support Liaison for my school, I have many of the parents calling me just to “vent”. I tell them all of the time just how hard their job as a parent really is and that it is not only OK, but expected for them to be overwhelmed and frustrated. Something new that I am working on this year is getting parents together to support each other. Soon, I will be hosting a monthly “circle of parents” virtual support group which will have targeted talks about current parenting stressors/issues and then give time for parents to connect, share stories, and help provide each other with support and strategies to get through it. I am really excited for this as it is so very much needed right now. Anonymous
I’d like to share something that we do in my classroom that shows great collaboration between Physical Therapy and the general education classroom. I have a student that attends PT outside the classroom twice a week but to sort of sneak in extra PT for the student our PT provided us with specific exercises or movements that the student is working on in an ongoing basis. We were then able to incorporate these exercises or movements into dances or movements that we then do with the whole class for “get the wiggles” out breaks. It is great because the student in need of PT gets about 2-3 mini sessions a day disguised as fun movement breaks that he is able to participate in with all his classmates. These breaks are beneficial for all the students. They look forward to them, enjoy them, and are refocused on the school work once they are completed. Best of all… it’s fun! Tim Fahey
I talked to a special education teacher who teaches in a high school life skills program. The PT used to come in her room and do whole-class activities. She said sometimes they would go outside or to the gym, depending on weather and the nature of the activities. He led the students in yoga, interval training, and dance parties (on holidays). During this time, he was able to target goals for specific students, while the entire class benefited from the activity. Rachel Stoudt
Our PT was so helpful for me last year, she gave me lots of great tips, especially when we were going on a field trip and I didn’t even think about how my student would get fatigued by the end- since she’s normally very peppy! Her advice to bring a wagon just in case saved our day. Anonymous
Recreation including therapeutic recreation
Recreation services can be provided throughout the school day or in after school programs. Recreation services can also set up arrangements with parks and community recreation departments. Therapeutic recreation can be used as a means to provide opportunities to help students improve hand and eye coordination, help reduce anxiety and behavioral issues, relaxation, trust, stress management, team building, and physical functioning. Tim Weatherford
School Nurse and Health Services
A school nurse does so much for a school to keep students safe. They have such a huge responsibility in these times of Covid to keep the school safe while also doing their duties they were doing before Covid as well. They have to constantly be near students with Covid symptoms as well, putting themselves at risk every day. I know the nurse at my school waits with the kids if they need to be sent home due to covid symptoms. The school nurse at our school also deals with angry parents who don’t understand why their child was sent home. I think a school nurse is truly one of the most important people at a school. Travis Rockett
School Psychologists (Psychological Services)
School psychologists do a lot of testing, that is for sure! These evaluations are so important though! They really can be the basis for eligibility, and if the student is found eligible for special education services, they will be a big piece in the development of the IEP. Also, the last evaluation a student has before the student graduates or turns 21 can be the document that will determine 504 eligibility, and will help determine other decisions such as guardianship. Some schools have their school psychologists do only testing, some schools will have them provide testing as well as counseling. The roles are really varied per school and district policies. Kari Grimes
I see our school psychologist always meeting with children as well as testing students with and for disabilities. They are never not busy. We have a high trauma population with so many of the students have some type of counseling services in their IEPs. This services is very important. I see how this gives these students a safe place to talk and express their concerns, which is what many of these students need. Anonymous
School Counselor (Counseling Services)
At my school, our school counselor introduces herself to students as the “feelings teacher”, and goes out of her way to get to know each student. I worked closely with her my first year at my school because she had a bond with the 1:1 I was assisting, and at that point I did not have a lot of experience working with students with high behavioral needs and different levels of trauma. She gave me tools and resources to learn from. Throughout Covid, she has invited students into a zoom room for lunch sessions with her, where students can just talk to her and a couple friends and hang out, eating lunch and bonding for 20-30 minutes. Anonymous
The social worker is the hub of community networking and support systems. Their knowledge of up to date resources can guide families to appropriate sources to help students. For example, a local social worker works with my church to help families in need during the Christmas season. Many of these families have children with disabilities. The church gathers wish lists from the social worker, and the congregation gets the items. The social worker and the church set up a wrapping and gift station on the top floor and child care with games, crafts, and snacks on the bottom. The parents load their trunks with the wrapped gifts and then gather their kids to take home (the children are not supposed to know where the gifts came from). I enjoyed meeting the social worker who worked on this last year and hearing how it has helped the families. Of course, gift-giving differs from connecting counseling or medical services – but I think it is important because it supports and encourages families with difficult challenges. Heather Roberson
When thinking about school social workers many people intertwine them with the guidance department and the school psychologist, when they actually have a very different role. A school social worker generally has their MSW or LCSW so they are skilled in helping individuals manage their mental health through different therapeutic tools. School psychologists generally do testing of students for special education and can be utilized as a resource for students and teachers to help students achieve academic success. While the school social worker wants students to be successful academically they often work with parents, outside therapists and school staff to create plans for students. While guidance counselors and school psychologists can both implement risk assessments for students if needed, guidance counselors primarily focus on career planning and class schedules. Jennifer Wylie
More and more school districts employ a wrap-a-round model of services, particularly for students and families who have multiple special needs, socio-economic, family dynamic and economic needs that can negatively impact a child’s ability to be successful in the school setting. Having the school social worker be part of the special education team for children with IEPs helps smooth transitions from school to home, focuses on the whole child and benefits the family…Sometimes just being able to consult with the social worker helps the educational staff be able to focus on the whole child. Resource: School Social Work Associate of America Jacqueline Godin
Social workers in our area have worked at ensure each student has internet access, food service drop offs, Chromebook pick up/drop off for students, and helping families to get financial support during school closures due to the pandemic. Alicia Jobson, Fall 2020.
Speech and Language Pathologist (SLP)
Speech-Language Pathologists responsibilities include evaluation, treatment planning and implementation, consultation, and material preparation to help students improve articulation, language, stuttering, voice deviation, and social language that would affect social/emotional regulation (Lombardi, 2020, Related Services section). As I spent a few hours reading articles about speech and language pathologists and related disabilities, I found that this is a very complex topic.
Classroom teachers, special education teachers, and SLPs share common goals for their students. The skills and knowledge of the SLP are complementary to those of classroom teachers, para-educators, and special education teachers who have students with speech and language impairments / communication impairments – creating a foundation for partnerships to benefit the students (Archibald, 2017). With collaboration, SLPs and teachers can support students more effectively in the classroom. Michaela Donati
Archibald, L. MD. (2017). SLP-educator, classroom collaboration: a review to inform reason-based practice. Sage Journals. https://doi.org/10.1177%2F2396941516680369
I recently sat in on a session with one of my second-graders and the speech and language pathologist (SLP) and was amazed at the amount of work she was able to get done in such a short session. She reviewed the plot of a book they had read the session before, worked on rhyming words from that story, and tapped out syllables in words from that story. She kept the student engaged the entire time, which also amazed me as this student often tends to daydream and zone out of the lesson. Plus, he comes across as very shy, but he loved chatting with her. She was also able to read his mood, and when she sensed that he was becoming fatigued, she introduced a game that would still work on his speech but would not come across as learning. She was truly incredible, and I can see why Professor Lombardi would consider her to be a teacher’s best friend. Mallory Wilson
I spoke with the Speech-language Pathologist at the school where I work and asked her to describe her role within our district. She is the speech-language pathologist at the elementary level, and is the preschool evaluator for our town as well. Her duties include: evaluation, treatment planning and implementation, consultation, and material preparation. The areas she specializes in include: articulation, language, stuttering, voice deviation, and social language that would affect social/emotional regulation. She also supports nonverbal students with Alternative Augmentative Communication. Judith Moore
Email correspondence with an SLP: As an SLP for CMS, I screen, assess, and treat students in grades K-5 with speech (speech sound disorders) and language delays and differences (related to receptive and expressive language skills, including those pertaining to understanding and use of vocabulary, morphology, syntax, story-comprehension/story-retell, and pragmatics/social communication skills.) Sometimes I also address eating and swallowing impairments in students, during Snack and Lunch.
Some students already identified with a Speech and Language Impairment, Developmental Delay, or Other Health Impairment, and they already have an IEP in place, prescribing speech or language therapy. Other times, kids are referred by either their classroom teacher, or their parents, by writing a referral. Then we meet with the parents and the rest of the child’s educational team, within 10 days. Then we talk about whether the team recommends formal testing, a screening, or some informal support, using a Response to Intervention approach, which is a tiered system of support available to all students.
If formal testing is recommended, I conduct a formal evaluation within 60 days, and write a formal report. That report goes home at least five days before our Determination for Eligibility meeting, with the team. If the child meets our eligibility criteria, either to be formally identified with a Speech and Language Impairment (or some other identification), we complete formal paperwork to identify the child, then meet within 30 days, to draft an IEP, with specific IEP goals, objectives, accommodations, and number of therapy sessions, per week (and sometimes consultation time Chelsea Hoadley
We have a full time SLP in each classroom at my preschool (4 total). Before working here, I did not realize how important and common these services are in education. Our SLP and Special Educator/Teacher co-teach during the week. I absolutely love this approach! Many of the lessons touch on both general education and the specialized services either need to deliver. I love watching how the SLP works her services into the lessons. We are constantly talking about what sounds each student is currently on and how I can help support her efforts throughout the day. Deanna Hanley
I chose to look into transportation services for students with disabilities because the quality of transportation services can influence a day before the student even walks through the front doors of the school. After all, the bus driver is often the first person from the school staff who interacts with students. Those early moments in the morning can really have an impact on students’ day starting off on the right foot.
An interesting part of providing transportation services under IDEA is travel training. Travel training is “instruction that enables children with disabilities to develop an awareness of the environment in which they live, and to learn the skills necessary to move effectively and safely from place to place within that environment (Questions and Answers on Serving Children with Disabilities Eligible for Transportation, 2009).” Travel training should be considered and included in a students’ IEP. Alicia Jobson
I never realized how important transportation services were until I worked in Intensive Needs and then Behavior Support. Our transportation department works closely with the Special Educators and Behavior Specialist on developing plans for children that struggle with the bus ride. We have identified a bus with one particular driver that only picks up certain children. It’s our “special ed” bus. The route covers the entire city and only picks up specific children. Having “Mr. Mike” pick them up is a big treat and each child looks forward to seeing him. I never thought about how important this was until I saw it in action. Sheri Gauvin
We have a wonderful group of bus drivers in my district who is in constant communication with us about students who may be having a tough morning and why. It is very helpful to know what is going on with the students before we get them into the classroom. We can often deescalate problems on the way in, with a joke and a smile to turn the day around. In return, we report back to the bus drivers before the bus ride home so they can be prepared as well. They are truly under appreciated! Deanna Hanley
Transportation is considered a related service when it comes to IEP students. A related service is something that benefits a students access to special education. “Transportation includes travel to and from school and between schools (or another location where services are delivered) and travel in and around school buildings. Additionally, supports a student needs, such as an aide, positive behavior support plan, and/or bus stop monitors, must be provided.” (car autism roadmap, n.d.) Transportation doesn’t just end when school ends either, if the student requires an ESY, then transportation must be provided for the student then too. Travis Rockett
CAR. (2020). TRANSPORTATION TO SCHOOL AND SPECIAL EDUCATION SERVICES. Car Autism Roadmap. From https://www.carautismroadmap.org/transportation-to-school-and-special-education-services/
Recently I have been mentoring a 1:1 aide who is new to working with a student who has a physical disability. The student she works with uses a wheelchair and, since his Mom brings him to and from school each day, had not ever ridden a bus since transferring to our school. In anticipation of an upcoming field trip, I set up training time for the 1:1 to see and learn how to load the student on and off the bus using the ramp as well as how to secure the student’s wheelchair using the tie downs and seatbelt on the bus. We also practiced bus evacuation in the case where the lift might not be working as well as what to do if the student has a seizure or needs any type of medical attention while the bus is in motion. I think it is VERY important for this to be done so that the child will be safe and so that all emergency situations will be well prepared for. Anonymous
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American Therapeutic Recreation Association. (n.d.). Information sheet: Recreational therapy and school systems. Hattiesburg, MS: Author. Available online at: https://www.atra-online.com/assets/pdf/Info_Schools.pdf
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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
National Institute on Deafness and Other Communication Disorders. (2016). Quick statistics about hearing. Bethesda, MD: Author. Available online at: https://www.nidcd.nih.gov/health/statistics/quick-statistics-hearing
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U.S. Department of Education, National Center for Education Statistics. (2016). Fast facts: Students with disabilities Washington, DC: Author. Available online at: