Why School-Based OTs Need an Intervention Plan for Each Student

Okay, so confession time: I’ve been slacking on this. I was loosely aware of school-based OT intervention plan requirements, but thought that the general template I’d been using to take notes was good enough. It wasn’t until I started reading through requirements again when preparing training material for new therapists that I learned that there was info that I should’ve already been including. And, second confession, even after learning this information, I didn’t have everything fixed in a day. Like most school-based OTs, the tasks on my plate are varied, time-sensitive, and often feel neverending. So I chipped away a little bit every day at changing over my template for each of my individual students. You can too!

School-Based OT Intervention Plan Legal Requirements

Let’s backtrack a little. Maybe you’re reading this and saying “Duh! You should’ve known that.” Or maybe you’re now wondering if your intervention plans are up to snuff. Or maybe you’re panicking because you’re now slowly realizing that IEP documentation does not usually cover the requirement that all OTs have to maintain an intervention plan for each client. 

I want to share a quote from one of my favorite publications, the Guidelines for Occupational Therapy and Physical Therapy in California Public Schools. I currently practice in California, so this manual is super relevant for me, but even if you don’t, it’s full of great info that is applicable to school-based OT in any state. Here’s what they have to say about intervention plans:

“Intervention plans are required under both OT and PT standards of practice, codes of ethics, and licensure regulations. (See www.bot.ca.gov; www.aota.org; www.ptbc.ca.gov; and www.apta.org for more information.)”

So, even if you’re not a California therapist, national codes of ethics and our practice acts require this. And, more than likely, your state practice act or licensure requirements do as well. 

What Should a School-Based OT Intervention Plan Include?

So that’s all well and good, but what does an intervention plan look like in the school setting? What do you need to include? Shouldn’t the IEP cover everything that would be in an intervention plan? 

Well, yes and no. 

Let’s see what my favorite guide has to say again: 

“The OTPA mandates that “An occupational therapist shall document his or her evaluation, goals, treatment plan, and summary of treatment in the patient record. Patient records shall be maintained for a period of no less than seven years following the discharge of the patient, except that the records of un-emancipated minors shall be maintained at least one year after the minor has reached the age of 18 years, and not in any case less than seven years” (BPC § 2570.185).”

“In addition to participating in the IEP process, OTs and PTs develop an intervention plan based upon the results of the assessment. The intervention plan is guided by multiple professional frames of reference linked to an intervention hypothesis and provides the clinical reasoning used to reach measurable goals. Measurable goals, the scope of intervention; treatment strategies; and frequency, duration, and outcomes of service are identified; and a pre-plan is made for discharge in line with IEP team and parent priorities.”

Again, even if you don’t practice in California, it’s likely that you are required to follow similar standards. And, worst-case scenario, no one ever got hurt from over-documenting (carpal tunnel syndrome aside).

In reviewing my own practice, I found that I was already most of the way there. And depending on how you do your daily notes, you probably are too! I use Google Docs to write short, narrative-style notes on each student as well as copy-paste any email communication. On this document, I was already including the student’s name, birthdate, IEP eligibilities, any relevant goals, number of treatment minutes, and their next planned annual/triennial.

While it’s not a requirement of school-based intervention plans, I also include details about their case manager, classroom teacher(s), and room number where I can find them. After reviewing multiple intervention plan/plan of care samples, I decided the only things I needed to add were specific medical diagnoses, precautions, and treatment strategies. While this may seem like a small list, I have to admit that it did take me a while to review reports and present levels from ~60 students so that I could capture the medical history and precautions accurately. 

Why Plans of Care Are Important

Eventually, I finished the file on my last student. And while it was a pain, I was happy to be compliant for multiple reasons. One, I was protecting my license. While this is an issue that most of us never have to face, legal situations happen and it’s possible attorneys or licensing boards will scrutinize your documentation. Even if you haven’t done anything wrong, it’s important to keep good documentation that isn’t easily picked apart. 

But more importantly, I was being a better OT for my students. While it’s easy to get frustrated with all the documentation requirements that come along with our profession, this one is rooted in a good place. Intervention plans, when they are fully fleshed out, give information that is not typically in an IEP.

This is especially relevant for me because I’m a travel therapist, which means I get a new caseload every year. Information left behind can be kind of a crapshoot – I’ve gotten everything from full paper files with work samples and daily notes to nothing at all. But in all cases, I was never handed over school-based OT intervention plans. If I was, I would’ve been able to serve my students so much more effectively.

I would’ve known exactly how the OT was supporting the student’s goals and what they had already tried. Hell, I would’ve known what goals the OT was even supporting – because let’s be real, there are a wide variety of standards when it comes to if OTs should have standalone goals or collaborative goals and if it’s just consult if they need a goal at all. I’ve sifted through many IEPs where it hasn’t been clear what exactly the OT was addressing. This is a problem in and of itself, but definitely something that could’ve been ameliorated had the OT attached a plan of care.

Going forward, I’m also setting up the next therapist for success. They will know if that ID eligibility is representing Down syndrome or agenesis of the corpus callosum or a specific genetic disorder. They will know that we tried a Twist N Write pencil and it really wasn’t that effective at the time. They will know who case managed the student when I was treating them. They will know if they need to be prepared to learn a seizure action plan or refrain from bringing in their peanut butter sandwich to this child’s classroom. They will know all of this before spending hours going cross-eyed reading IEPs, especially if it takes a while to get set up on the district’s system, as it so often has for me. They will know how to be the best OT they can be for this child, in part because I made sure that’s what I did. 

If you’re thinking about creating a school-based OT intervention plan for the students on your caseload, but have no idea where to start, I’m offering my template for free. Just drop your email below! You will receive a confirmation email and then a second email with the template – check your promotions or spam folder if you don’t see it.

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