IEP And IFSP 101: Everything You Need To Know From Planning to Implementation

Introduction

I am an educator who specializes in working with students and families who need additional support in the school system. Questions I typically get from educators and other related service therapists include how is an IEP or an IFSP plan written, who is involved in the meeting, how do I write an appropriate goal, and, where am I able to work with these students once I am in the school? My hope is that today the information shared will clear up some of these questions that you might have on the process and help you to take an active role as related service personnel if needed.

IEP/IFSP-What Does This Mean?

• IEP is an Individualized Education Program, although it is sometimes referred to as an Individualized Education Plan.
• IFSP is an Individualized Family Service Plan and serves younger children from infancy through two years old.

An IEP is an Individualized Education Program, although sometimes you will hear it referred to as an Individualized Education Plan. An IFSP is an Individualized Family Service Plan and serves younger children from infancy through two years old. Typically, this plan is valid until the child's third birthday. However, there can be exceptions depending upon the area you live in.

Individualized Family Service Plan

• The IFSP should guide and support the entire family as the parents are a vital part of this process.
• The IFSP team typically involves the parents, service coordinator and various specialists such as an Occupational Therapist, Speech-Language Pathologist or Physical Therapist.
• There is a wide range of services that are available for a child qualifying for an IFSP.
• The IFSP team will meet to review the plan biannually and make revisions annually.
• Progress updates should be provided to the family quarterly.
• It is important to note that parents are legally entitled to change or even decline services throughout the IFSP process.

The ISFP should guide and support the entire family as the parents are a vital part of this process. The IFSP team, typically, involves the parents, service coordinator, various specialists such as occupational therapists, speech-language pathologists, or physical therapists. There is a wide range of services that are available for these young children that qualify for an IFSP. So, other services might be health services, developmental, and/or play therapies. These types of programs are a great opportunity to work with these children in the home environment. An occupational therapist could work with the child from infancy through two years old. They can work with them on fine motor skills, sensory needs, and other types of tactile skills that they might be needing. Progress updates should be provided to the family quarterly, and the team meets annually. The IFSP plan is in place until the child is three years old. The child can then qualify for additional services once they are school age. However, in cases where there is no public preschool, this age range may extend to 5 years old. 

What Happens Next?

• The child will be re-evaluated before turning three years old to determine if services are still needed.
• If services are needed, the special education teacher and specialists will meet with the family to develop an IEP for the school system.

What happens next? The child will be reevaluated before turning three years old, to determine if services are still needed. As I was saying, the IFSP will just go until three years old, and then the team will reevaluate the child and see if the student still needs services at school age. If services are needed, the special education teacher and specialist will meet with the family to develop an IEP for the school system. And in the case of occupational therapy, the same therapist could with the child as they enter school. It is really helpful for children to have the same therapist when available as they know the child, what works, and what does not work. So, when it is possible, the team tries to keep the occupational therapist with the same child.

Individuals with Disabilities Education Act (IDEA)

Under the Individuals with Disabilities Education Act, which you will hear it often called IDEA, there are 13 qualifying disability categories to identify for special education services and to receive an IEP in the school setting.

• Autism Spectrum Disorder (ASD)
• Intellectual Disability
• Deaf-Blindness
• Deafness
• Emotional Disturbance
• Hearing Impairment
• Multiple Disabilities
• Orthopedic Impairment
• Other Health Impairment
• Specific Learning Disability (SLD)
• Speech or Language Impairment
• Traumatic Brain Injury (TBI)
• Visual Impairment
  • Includes Blindness

Within the IDEA definition, every child has a legal right to a free appropriate public education. We will spend a little bit more time elaborating on these 13 categories and how it relates to the occupational therapy field.

Autism Spectrum Disorder (ASD)

• Exhibit a wide range (spectrum) of characteristics and symptoms
• Express difficulty with social skills and communication
• Engage in excessive repetitive behaviors
• Typically diagnosed at a young age

Students with ASD typically have a wide range of characteristics and symptoms. Obviously, this is where the term spectrum comes from. Students might have difficulty expressing social skills and communication, and some may even be nonverbal. Students with autism spectrum disorder can engage in excessive repetitive behaviors. For example, they could do the same types of hand movements over and over. This disability category is typically diagnosed at a young age. Occupational therapy intervention may include fine motor skills, such as buttoning or snapping clothing, self-help skills, sensory modulation, and play therapy.

Intellectual Disability

• This disability category was previously referred to as Mental Retardation (MR) in 2010.
• Limited intellectual and adaptive functioning
• IQ level below 70
• Mild, Moderate, Severe and Profound are the degrees of Intellectual Disability.

This category was previously referred to as mental retardation (MR) up until the year 2010. Students with intellectual disabilities have limited intellectual and adaptive functioning. Their IQ level is below 70. The IEP will be listed with one of these degrees of disability category so either mild, moderate, severe, or profound. Students in this category would benefit from OT services for problem-solving skills, fine motor tasks such as writing, typing, and cutting, and self-help skills. The therapist can help to transfer these skills to home by getting the parents involved. Some of the self-help skills include bathing, brushing teeth, eating with utensils, and using the restroom independently. There are also many types of devices and equipment that are available.

Deaf-Blindness

• Combination of sight and hearing loss
• Exhibits some vision and audible range
• Students may need additional support outside of their school program
  • Educational Audiologist
  • Speech Pathologist
  • Vision Specialist

Students have a combination of sight and hearing loss in this disability category. Again, occupational therapists can assist students with sensory integration and tactile recognition. Some examples might include using tangible items to represent activities and to assist with transitions. In the classroom, the occupational therapist can assist the teacher with routines and activities.

Deafness

• Hearing loss - Severe to profound levels
• Typically hearing loss above 90 decibels is considered deafness
• Does not necessarily impede cognitive ability for the child 
• Assistive technology and hearing devices can significantly improve the classroom experience.

This category is severe to profound levels of hearing loss. Students who qualify for this disability category have a hearing loss above 90 decibels. This does not necessarily impede their cognitive ability. Occupational therapists can help students in this disability category with vestibular rehabilitation and to prevent motor delays.

Emotional Disturbance

• IDEA defines emotional disturbance as “…a condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a child’s educational performance: 
  • An inability to learn that cannot be explained by intellectual, sensory, or health factors. 
  • An inability to build or maintain satisfactory interpersonal relationships with peers and teachers. 
  • Inappropriate types of behavior or feelings under normal circumstances.
  • A general pervasive mood of unhappiness or depression. 
  • A tendency to develop physical symptoms or fears associated with personal or school problems.”

The next disability category can sometimes be difficult to qualify for a diagnosis and related services might not be considered in this category until the effects of the disability become more severe. IDEA defines emotional disturbance as a condition exhibiting one or more of the following characteristics over a long period of time to a marked degree that adversely affects the child's educational performance. Occupational therapy could be beneficial for students qualifying for emotional disturbance by focusing in on social skills, problem-solving, turn-taking, and regulating behavior. Again, this disability category can sometimes be tricky to diagnose, and it might be an older child at the school-age level.

Hearing Impairment

• Hearing loss – Mild to moderate levels
• Typically hearing loss below 90 decibels is considered hearing impairment
• Many students can be mainstreamed with some assistance.
  • Hearing aids, cochlear implants, speech therapy, and assistive listening devices

Hearing impairment is when the child's hearing loss is at the mild to moderate level. This one is below 90 decibels. This is different than deafness. OT can assist students with hearing impairments in the general education environment with assistive technology. Many students can be mainstreamed with some assistance while using different technology devices.

Multiple Disabilities

• Combination of more than one disability category
• Typically listed along with other disabilities in the IEP health section
• Students often need a variety of supports for all areas of life.

The IDEA classifies a student with multiple disabilities when there is a combination of more than one disability category identified for the child. These are typically listed in the IEP health section. An example would be if a student has maybe an emotional disturbance and deafness. Thus, they have two different categories for which they qualify. Occupational therapy and other related services would be based on the need of the student and on an individual basis. As this category can have various types of disabilities, it really needs to be developed on an individual basis.

Orthopedic Impairment

• Severe orthopedic impairment that affects the child’s ability to succeed in school
• Impairments caused by birth defects, illnesses or other factors such as injuries
• Students typically need physical and communication supports.

Next is the orthopedic impairment disability category. Occupational therapy is commonly referred for students with an orthopedic impairment more than any other IDEA disability category. A student will qualify if he or she has a severe orthopedic impairment that affects the child's ability to succeed in school. Impairments can be caused by birth defects, illnesses, or other factors such as injuries. Students typically need physical and communication supports to be successful in the classroom. Interventions include fine motor skills, self-help skills, and any needed modifications. Typically, the school will help provide some of these adaptive equipment devices. It is so important to list these devices in the IEP in writing because that is a legally binding document. If the team determines that a device is needed, it needs to be in the IEP so that it can be followed no matter who is working with the student.

Other Health Impairment

IDEA defines other health impairment as “…having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that—

• Is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and Tourette syndrome; and
• Adversely affects a child’s educational performance.”
• Qualification for this disability category will occur only if health impairments severely impact the student’s education.

This next category can be a little tricky based on the definition. This is the other health impairment disability category. The IDEA defines this health impairment as having limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment. This can be due to chronic or acute health problems such as asthma, attention deficit disorder, attention deficit hyperactivity disorders, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, or leukemia. Qualification for this disability category will occur only if health impairment severely impacts the student's education. This is a team decision, and the whole team must work together to see if the child's health is really impeding their academic or independent status.

Specific Learning Disability

• “Specific learning disability means a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written, that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations, including conditions such as perceptual disabilities, brain injury, minimal brain dysfunction, dyslexia, and developmental aphasia.”
• Typically diagnosed in elementary school

Specific learning disability is our next category. This is defined as a disorder in one or more of the basic psychological processes involved in understanding or in using language spoken or written that may manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or do mathematical calculations. This can include conditions such as perceptual disabilities, brain injuries, minimal brain dysfunction, dyslexia, and developmental aphasia typically diagnosed at the elementary school level. Occupational therapists can play a big role in this disability category.

Speech or Language Impairment

• Communication disorder that adversely affects a child's ability to talk, understand, read and write
• Typically common traits will emerge at a young age and early intervention is key.
• This disability can be in combination with other disability categories on the IEP.

This is another way a child will qualify for specialized services. It is a communication disorder that adversely affects the child's ability to talk, understand, read, or write. Typically, common traits will emerge at a young age, and early intervention is key. This disability can be in combination with other disability categories on the IEP. An OT can provide support and collaborate with the speech-language pathologist in this section. 

Traumatic Brain Injury

• Injury caused to the brain from an external physical force such as falls, violence or vehicle collisions
• Hereditary brain injuries, degenerative conditions or injuries caused to the brain by birth complications do not fall under this category.

Next is the category of traumatic brain injury. This is a brain injury from an external physical force such as a fall, violence, or a vehicle collision. This is a disability category that is not from a hereditary brain injury, degenerative condition, or injuries caused during birth. Again, the OT can assess self-help, motor, and cognitive skills to form an intervention plan.

Visual Impairment

• Impairment in vision significant enough to impede educational performance
• Includes partial sight and blindness
• Assistive technology can significantly improve the classroom experience.

Lastly, the 13th IDEA category is visual impairment. This is where the child's vision is significant enough to impede their educational performance. The student will have partial sight or blindness. Assistive technology can significantly improve the classroom experience. A great example that I have seen used in the classroom is a tool called a lightbox. An OT can assist the students and special education team with any needed adaptations to help the child to succeed.

Individualized Education Program (IEP)

• The IEP is a customized plan for school-age students (3 –21 years old) who qualify for special education services.
• Parents are legally obligated to be apart of all decision making and notified of all assessments taking place.
• Quarterly updates and annual meetings
• Schools receive additional funding
• IEP team (special education teacher, general education teacher, related services) are accountable for making progress and enhancing student goals.

Now, let's move on to the individual education program. This is a customized plan for school-age students three through 21 years old. The plan actually expires on the client's 22nd birthday. The student is then going to be working on a post-high school type program at that point. Parents are legally obligated to be a part of all the decision making and notified of all assessments taking place with the child in the school. Thus, it is important to keep parents in the loop with quarterly updates, and the annual meetings are a requirement. Schools receive additional funding for a student that has an IEP, and that is actually where some of the funding comes from for occupational therapy, technology supports, speech services, adaptive equipment, etc. The IEP team is made up a special education teacher, general education teacher, and then related services such as occupational therapy, physical therapy, and speech-language services. 

What is Another Option?

• If a student has significant limitations and does not qualify for an IEP, Section 504 of the Rehabilitation Act might be the best option.
  • Commonly referred to as a 504 plan
• This plan provides additional support and is protected under the Americans with Disabilities Act (ADA).
• There are no legal requirements for a written plan and parental involvement.
• Schools do not receive additional funding for students with 504 plans.

For some students, there is another type of plan. If a student has a 504, the student does not qualify for an IEP. According to AOTA, "students who are not eligible for special education may receive occupational therapy services under a Section 504 plan. Services are designed to ensure students have equal access to all aspects of the school day and support student participation and success in general education." Here is AOTA's fact sheet on school settings for more information.

Key Terms

• Commonly referred to as the “alphabet soup” of abbreviations during IEP meetings
  • SPED – Special Education
  • BSP – Behavior Support Plan
  • FAPE – Free Appropriate Public Education
  • EI – Early Intervention
  • LRE – Least Restrictive Environment
  • OT – Occupational Therapy
  • PT – Physical Therapy
  • SLP – Speech-Language Pathologist
  • AT – Assistive Technology

As you can see, there are many abbreviations used daily in the school setting. This can be confusing and unclear to not only parents but teachers and therapists as well. It is important that everyone on the team understands these terms. This first one SPED which if special education. BSP is a behavior support plan and FAPE is a free appropriate public education for a child. EI is early intervention, and you will see this one a lot more when working with the IFSP with those younger students. LRE stands for the least restrictive environment. This is the term used when attempting to find the most appropriate physical environment for the students. This term is really important as the team needs to determine the least restrictive environment that the child. We want the child to be mainstreamed as much as possible. This can either be full-day, part-time, a specific class a day, or for specials like PE, music, art, or even recess or lunch. This might change over the year with either increasing or decreasing that time. I am sure you are all familiar with the therapy terms. Lastly, I want to point out that AT means assistive technology. I am sure this is a review but for some of you that are working outside of the school setting, but I wanted to just touch base on those terms so when you do come across those abbreviations or acronyms then you will be a little bit more familiar. You do not want to overuse some of these abbreviations as they can be confusing to families that are involved.

Understanding the IEP Process

1. Referral
   1. Students can be referred by parents, healthcare professionals or the special education team.
2. Evaluation
   1. Assessment tools, observation, and data will help determine whether a student qualifies for an IDEA disability category.
   2. Must have parental permission
3. Eligibility
   1. If the student is eligible for special education services, the IEP process begins.
4. Development of the IEP
   1. The IEP team will start collaboratively developing the plan.
   2. The IEP plan must be created thirty days from eligibility determination.
5. IEP Meeting
   1. The teacher will set a meeting date with the parents.
   2. It is also a requirement to notify the parents at least two times prior to the meeting date.
   3. The IEP plan is a rough draft until the meeting is complete.
   4. Meetings can be held by phone with parental permission (not recommended unless necessary).
   5. Related services will be determined during the meeting.
6. Implementation
   • The IEP will commence with the needed support

• Student progress is measured and evaluated based on the determined timelines set in the IEP plan.
• The IEP team should review goals quarterly and provide updates to the parents.
• The IEP plan is reviewed and revised annually with the IEP team including parents.
• The student should be re-evaluated every three years to determine if services or environments need to be revised.

There are many steps in the IEP process, and it typically begins when a student is referred for an evaluation.

Referral

Students can be referred by parents, healthcare professionals, the special education team so, or a related service team member. 

Evaluation

It is important to note that, as we have mentioned already, parental permission must be obtained for all assessments for students. There needs to be written consent for any type of assessment.

Eligibility

If the student is eligible for special education services then the IEP process begins. The IEP team will start collaborating and developing that plan together, and the IEP plan must be created within 30 days of the assessment. 

Development of the IEP

During this process, you start off with a rough draft.

IEP Meeting

The rough draft to the IEP meeting. The IEP meeting should include the administrator, teacher, related service members, and family members. It does take a little bit of time to get all of those schedules coordinated and get this planned in that 30-day window. You have the first initial one, and then every year there will be another meeting to review the plan. As I mentioned, related service personnel (ie. OT) need to be present for all meetings. However, you can be excused from a meeting with written consent.

Implementation

The IEP will commence with the needed support. As an OT, you will be responsible for providing any present levels, progress notes, and annual goals for that meeting. Additionally, the OT and the team need to provide a SMART (Specific, Measurable, Achievable, Relevant, Time-Bound) goal for the child to work on within that year of the plan. The responsible parties will start implementing the IEP goals and the needed accommodations. Student progress is measured and evaluated based on the determined timelines that were set in the IEP plan. The IEP team should review view goals quarterly and provide updates to the parents. Progress is monitored to provide quarterly updates to the parents. Different school systems have different systems set up. In a bit, we are going to look at an IEP from Indiana, however different states have their own system. There is beginning to be some uniformity so that tracking can occur within each state and even state to state, but not all states are using the same system. For example, in Indiana, if a student moves from a district to district, most of the time that IEP can be tracked and found within the system. This is a good system so that you can have the IEP from the previous school or previous year and not have to start from square one. 

Legal Requirements

• The Individuals with Disability Education Act (IDEA) is a federal law to provide rights to students with disabilities.
• The IEP plan is a legally binding document mandated by the IDEA.
• The IEP must be followed by all parties involved or legal ramifications could take place.

The IEP is a legally binding document falling under IDEA. The 504 plan does not have as many of the same parameters set up as the IEP. The IEP must be followed by all parties involved or legal ramifications could take place. The whole team needs to be familiar with the IEP, the goals, and the accommodations. 

• Under the IDEA, the purpose is stated as …“To ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living;
  • To ensure that the rights of children with disabilities and their parents are protected;
  • To assist States, localities, educational service agencies, and Federal agencies to provide for the education of all children with disabilities; and
  • To assess and ensure the effectiveness of efforts to educate children with disabilities.”

Under the IDEA, the purpose of the IEP is to ensure that all children with disabilities have available to them a free appropriate public education that emphasizes special education and related services designed to meet their unique needs and prepare them for further education, employment, and independent living. Additionally, this is to ensure that the rights of children with disabilities and their parents are protected, to assist states, localities, educational service agencies, and federal agencies to provide for the education of all children with disabilities and to assess and ensure the effectiveness of efforts to educate children with disabilities.

What Needs to be Included in the IEP?

1. Present levels
   • Gain rapport with family
   • Positives are important!
2. Annual goals
   • Specific, Measurable, Attainable, Realistic and Timely (SMART)
3. Related services – Occupational Therapy, Speech, Physical Therapy
4. Accommodations and program modifications

• Include duration of time with general education peers
• State and district testing accommodations
• Approximate timeline of services
• Other considerations (when needed)
  • Transition Plan – Starting at 14 years old
  • Extended School Year
  • Nonacademic Services
  • Transportation Services

Now that we have talked about the legal requirements, let's look at the actual plan. There are four sections that I feel are the most important to touch base on in our short time today. The first is the present levels. It is important to showcase the student and include lots of positives. This is a great way to gain rapport with the student and family. Of course, everyone wants to hear all the wonderful things that the child is doing. Typically, the related service personnel can provide that to the teacher and the teacher will put that into the IEP. I often tell teachers to use the sandwich method in this section. An example of this is to start by sharing a positive or an engaging story of the student. "Susie really likes going to gym class with her peers." This is something that has been exciting to the student or where they have been doing well. The teacher can then move on to then the meat of the sandwich and share some of the concerns. These could be test scores or behaviors that the student has been portraying. Then, they would finish up with other positives and/or hopeful recommendations moving forward with the school year.

Annual goals are next. It is important that you are familiar with SMART goals (specific, measurable, attainable, realistic, and timely). An example might be, "Susie will identify seven of 10 sight words each week for the first quarter of school." If the meeting is not an initial IEP, then the team should discuss the past goals and any progress that was made. Use the documentation to then develop the new annual goals. It is okay to continue a goal, but it is important to change it in some way each year so that each IEP is unique.

The next section includes related services. As each student has a unique plan, this does not necessarily mean that every student will qualify for special education services. Besides therapies, some of the other types of related services might be nurse services, social work, or counseling. I had a student, for example, that had to be tube-fed. Thus, the nurse had to be a part of that IEP team. Once something is a part of the plan, all personnel need to follow all the accommodations that are listed.

Accommodations and modifications are a vital part of the IEP plan as well. Sometimes people get confused about the difference between these two terms. Typically, a modification is a change of what is being taught or what is expected from a student. And on the other hand, accommodation is a change that helps a student overcome or work around the disability or learning challenge. An example of an accommodation might be for a student to be allowed to provide the answer to a test question orally or typed versus handwritten. Modifications and accommodations are both ways of helping the student, but it is important to determine which is the most appropriate strategy and identify it correctly on the IEP plan.

Parent and Educator Roles

Required IEP Team Members

• Family – Student if appropriate.
• General education teacher
• Special education teacher
• Administrator
• Other specialists providing services
  • OT, PT, SLP, Vision, Hearing, Nurse

Meeting Objectives

• Advocate for the student
• Teamwork
• Parental input
• Child-first language
• Prepared and organized
• Provide data documentation
• Stay calm and unbiased

IEP Sample

Now, I would like to take a few minutes to show you a blank IEP sample. As I mentioned, I am from Indiana so this is a blank IEP plan from Indiana. Each state could look different, but there should be similarities across each state. I am going to share my screen to show you this sample. 

Parent and Educator Roles

Required IEP Team Members

• Family – Student if appropriate.
• General education teacher
• Special education teacher
• Administrator
• Other specialists providing services
  • OT, PT, SLP, Vision, Hearing, Nurse

You should be familiar with this now. We have talked about how the family, the general education teacher, special education teacher, administrator, and related services all should attend.

Meeting Objectives

• Advocate for the student
• Teamwork
• Parental input
• Child-first language
• Prepared and organized
• Provide data documentation
• Stay calm and unbiased

It is really important to advocate for the student. We all need to share with the team what we are seeing and what we believe will really benefit the child moving forward. There should be a good collaboration, and even if you disagree with another team member, it is important to work together to come up with a plan that will be really beneficial for the student. If there is anything that needs to be changed throughout the year, that is fine. The teacher can open back up to the IEP with the parents' consent and make any changes that are needed, The parental input is crucial as they know their child best. And in most cases, we need to hear from the parents what is working at home and what is not working.

I also wanted to touch base on child-first language. This is a new term that you may or may not have heard of before. This is focusing on the child and not the disability when talking to others. It is also important to come to the meeting prepared and organized. Remember that the IEP meeting is to develop a rough draft. You do not want to come to the meeting saying the goal you have developed as it is a team decision. Bring your data and make sure that you have your documentation to back up your recommendations. Try to stay calm and unbiased. We want to make sure that everyone's voice is heard including the parent's and child's.

Key Takeaways

• Plans should always be unique and individualized  - Not one size fits all!
• IFSP - Ages infancy through 2 years old (some exceptions)
• 13 IDEA categories
• IEP vs. 504 plans
• Be mindful of abbreviations and jargon
• Cooperation and collaboration will make for a more effective experience.

The plan is not a one size fits all model. It is a unique and individualized plan. If you want to continue some of the goals year to year, it is important to always make some type of change within the goal because the IEP should never look exactly the same. The IFSP is through two-years-old in most cases. At the age of three, you will be determining whether the child is qualified for an IEP in the school setting. There may be some differences state to state and district to district. There are 13 IDEA categories we covered today. Typically, an occupational therapist would not work with students on a 504 plan; however, there may be some exceptions. Check out AOTA guidelines. Be mindful of those abbreviations and jargon we talked about previously, and, again, cooperation and collaboration will make for a more effective experience when writing an IFSP or IEP.

References

• Occupational Therapy in School Settings. Retrieved from https://www.aota.org/~/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/CY/Fact-Sheets/School Settings fact sheet.pdf
• Understood- Learning and Attention Issues. Retrieved from https://www.understood.org
• Individuals with Disability Education Act. Retrieved from https://sites.ed.gov/idea