How School-based OT Services Differ From Special Education Services

Last week, I received a question I knew I would have to address in an article one day... Well, that day has come.

In response to my occupational therapy services in high school article, Meghan asked:

“What about this is specific to OT versus special education or other IEP team members?”

While her question was tied to supporting older students, it could just as easily apply to all school-based occupational therapy.

And honestly, I would be lying if I said I’ve never asked myself this same question while sitting in IEP meetings, observing classrooms, or even while working one-on-one with students.

The truth is, while what we do can sometimes look similar to what a teacher does, the actions we take and the reasons behind them are very different.

So let’s talk about it. Not from a place of defensiveness or turf protection, but from a place of clarity.

Why This Question Comes Up So Often

This question comes up because schools are changing, and with it, so are how OT servies are provided.

We’re seeing more inclusive practices, more push-in services, more collaboration, and more emphasis on real-world skills. Teachers are thinking beyond academics. Special education services are increasingly focused on functional outcomes. Speech therapists are working on participation and self-advocacy. Mental health supports are embedded across settings.

All of that is good.

But when everyone is supporting similar outcomes, it becomes harder to articulate why occupational therapy is at the table, especially if our answer starts sounding like, “Well… we all kind of do this.”

Overlap among providers is not the problem. Lack of role clarity is.

So, how is OT different from Special Education services? IDEA is a good place to start to answer that question.

SDI vs Related Service

One of the most important distinctions to understand is how IDEA views the two different services.

Special education services exist to provide specially designed instruction (SDI). The purpose of instruction is to teach a student new skills, content, or strategies aligned with educational standards and goals.

IDEA, as well as AOTA’s Guidelines for Occupational Therapy Services in Early Intervention and Schools, make it clear that school-based occupational therapy is not an instructional service. As part of an IEP, we are not in schools to teach reading, writing, math, or curriculum content, and we are not responsible for designing or delivering academic instruction.

Instead, occupational therapy is considered a related service under IDEA. That means our role is to support access, participation, and performance within the educational environment.

• Access: Can the student physically, cognitively, and emotionally engage with classroom activities and routines?
  

• Participation: Can the student take part in school tasks alongside peers in meaningful ways?
  

• Performance: Can the student carry out those tasks effectively and with increasing independence in real classroom contexts?

So while a teacher may be responsible for teaching a skill, an OT practitioner looks at what might be preventing the student from using that skill in the classroom, whether that barrier is related to the environment, task demands, tools, routines, or supports.

OT services are provided when they are necessary for a student to benefit from special education. Not to replace instruction, and definitely not to duplicate it.

Teaching Skills vs. Enabling Use of Skills

Here’s a simple way I often think about it.

Special education teachers often ask themselves: “How do we teach this skill?”

Instead, we as OTPs are tasked with answering, “What is getting in the way of this student using the skill here?”

We are trained to analyze the interaction between the student, the task, and the environment. Not in isolation, but together. This perspective is foundational to occupational therapy and is explicitly described in the Occupational Therapy Practice Framework (OTPF-4).

Example of the Teacher & OT Roles:

A teacher may notice that a student understands writing concepts but struggles to stay focused long enough to complete written work. While the teacher can re-explain directions or provide instructional support, the barrier isn’t the writing skill itself. Rather, it’s sustained attention during the task.

In this situation, OT wouldn't focus on the writing. Instead, OT focuses on analyzing what is interfering with attention and engagement, such as task length, visual demands, seating, or the structure of the writing routine.

By adjusting these factors, the OT helps create the conditions that allow the student to remain engaged and use the writing skills they’ve already been taught.

The OT Lens & Looking Beyond the Student

This is where occupational therapy most clearly differs from special education services.

While educators understandably focus on instruction, progress, and outcomes, OT practitioners are trained to look beyond the student alone and examine:

• The demands of the task

• The physical, social, and sensory environment

• The routines, expectations, and supports surrounding performance

Our evaluations and interventions are not only about determining whether a student can do something in a controlled setting, but also whether they can do it within the actual occupations of school, such as writing during timed assignments, managing materials between classes, participating in group work, navigating transitions, or using assistive technology independently.

This is also why classroom observations and occupational profiles are so central to school-based OT practice. They help us understand performance from the student’s perspective, across contexts, rather than through isolated skill testing.

Even Then, Overlap Happens. That’s Not a Problem

Executive functioning. Self-regulation. Written expression. Transition skills.

These are areas where occupational therapy, special education, speech therapy, counseling, and even general education often overlap. That overlap doesn’t mean services are redundant. It means teams are addressing complex skills from different angles.

• The special education staff may try teaching strategies explicitly.

• The OT may help the teacher modify task demands, environmental supports, or routines so those strategies can actually be used.

• Meanwhile, the SLP may support communication demands tied to the same activity.

Let’s look at an example.

A teacher instructs the entire class on how to copy assignments from the board into their agenda. Within a few days, most students have the routine down, but not Timmy. As you might expect, this is frustrating for Ms. Jones, who doesn’t have the time to "re-teach" this task to Timmy week after week.

Enter you, the OT practitioner.

You’re likely not going to pull Timmy out, practice copying from the board in isolation, and send him back to class. That would simply replicate what the teacher already did, and would likely lead to the same result.

Instead, you observe Timmy attempting the task in the classroom. You talk with Ms. Jones about what she’s noticing. You check in with Timmy about what feels hard. You may assess visual processing, attention, or organizational demands before making any recommendations.

Only then do you intervene based on what you learn about Timmy, the environment, and the teacher's expectations for the student.

Maybe the solution is a seating change. Maybe it’s a simplified agenda format. Or maybe you discover that Timmy is intentionally avoiding writing assignments so he can later tell his parents he has no homework.

Whatever the outcome, the key point is this:

Your recommendations are not guesses. They're not even "educated guesses." They are the result of the occupational therapy process, grounded in observation, analysis, and professional reasoning.

Could Ms. Jones have tried a different seat or a simpler agenda? Possibly. But those decisions would likely be based on intuition alone, not on a structured occupational therapy framework designed to analyze participation within real classroom demands.

That distinction matters.

How I Try to Reduce Confusion of What OT Is

One way to reduce confusion is to be very clear about accountability. And the best time and place to do this is often the IEP.

During the IEP, you likely have a moment to explain what OT is, and how you plan to support a child. This is your chance to explain your role while the parent(s), Teacher(s), and even the Admin are tuned in only to you. So use that time wisely.

Here's a script you can even use in your next IEP to help others better understand your role. It may even help you to be more confident in your role.

“My role as the OT is to support [student]’s access, participation, and independence within the school environment. I’m here to look at how educational task demands, routines, and environmental factors may be impacting [student]’s ability to use the skills they’re being taught. When challenges come up, I can work with the student and/or the team to identify what might be getting in the way and to recommend supports or adjustments that help [student] participate more fully and successfully throughout the school day, and I’m happy to build on that as we talk more about [student]’s needs.

Note, there's nothing about handwriting, sensory, executive functioning, or behavior here. Instead we focus on task demands, routines, and environmental factors. That leaves the door open for us to support in many different ways.

Still sorting out the role of school-based OT?

You don’t have to do it alone.

Understanding the difference between school-based OT services and special education instruction isn’t always straightforward.

Inside The Collab, school-based OTPs come together to talk through these exact questions. You’ll find:

• school-based CEUs designed around real educational roles

• peer discussion and mentorship when role confusion comes up

• practical tools and language to clarify OT’s contribution on IEP teams

• support applying evidence in ways that align with school systems

If you’re looking for ongoing support to confidently navigate your role — not just read about it — The Collab is where learning turns into practice.

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Common Misunderstandings That Get in the Way

I often hear things like:

• “A teacher can suport (insert skill here), so why do they need OT?”

• “If I push in to a classroom, how is what I do different from a paraprofessional?”

• "If a teacher is addressing ADLs, then why should I?

So let's address the reality of each of these, one at a time.

“A teacher can support [insert skill here], so why do they need OT?”

Teachers often support the same skills OT practitioners address, but OT focuses on identifying and reducing the barriers that make it hard for a student to use those skills in daily school routines. OT supports access and participation so instruction is more effective, rather than replacing the teacher’s role.

Often, a teacher does effectively support a student. And when they do, they tytpically don't ask for more help. If they are coming to you, it is because they need assitance.

“If I push into a classroom, how is what I do different from a paraprofessional?”

Paraprofessionals provide ongoing assistance, often with little training or guidance. OT practitioners focuses on determining what supports are needed and how to fade them over time - something that paraprofessionals are not paid or expected to do.

When you push in, you're observing, analyzing, and collaborating to adjust supports with the goal of increasing independence - not just helping the student in the moment.

“If a teacher is already addressing ADLs, why should OT?”

Teachers may support ADLs as part of the school day, especially in transition programs. However, OT looks at ADLs through a participation and independence lens, analyzing why tasks are difficult and how routines or environments can be adapted to promote long-term autonomy.

I have found that most teachers appreciate the guidance I can provide on supporting ADL skills - even if I only via a once a year consult.

Remember, we are not there to compete with instruction. We are there to support instruction.

Practical Takeaways for OT Practitioners

To wrap up, if you’ve ever struggled to explain your role (or even to believe in your own role as an OTP), here are a few anchors that can help:

• Focus on participation, not just skills

• Describe your role in terms of access and independence

• Emphasize collaboration, not ownership (especially when it comes to IEP goals)

• Frame OT as enabling instruction, not duplicating it

IEPs work best when we work as a team with out special education colleagues.

We serve the same students. We share the same goals. But we bring different training, perspectives, and responsibilities to the team.

And when we lean into that, students are better supported.

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Resources & References

• American Occupational Therapy Association. (2017). Guidelines for occupational therapy services in early intervention and schools. American Journal of Occupational Therapy, 71(Supplement 2), 7112410010. https://doi.org/10.5014/ajot.2017.716S01

  
  

• American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process (4th ed.). American Journal of Occupational Therapy, 74(Supplement 2), 7412410010. https://doi.org/10.5014/ajot.2020.74S2001

  
  

• American Occupational Therapy Association. (2021). Improve your documentation and quality of care with AOTA’s updated occupational profile template. American Journal of Occupational Therapy, 75(Supplement 2), 7502420010. https://doi.org/10.5014/ajot.2021.752001

  
  

• Individuals with Disabilities Education Improvement Act of 2004, 20 U.S.C. § 1400 et seq.