What Are Related Services in an IEP?

Article
May. 31, 2022Updated Sep. 29, 2022

It’s important to remember that, according to Wrightslaw, IDEA’s “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.” Here are a few of the services commonly provided to students that are not explicitly listed under IDEA’s related services section:

  • Adapted Physical Education (APE): IDEA describes physical education as including “special physical education, adapted physical education, movement education, and motor development.” In California, adapted physical education, or APE, is provided as a related service. An APE therapist provides accommodations or modifications to the gen ed PE program as either a pull-out or push-in service, or both. While APE therapists do not have the breadth of training and knowledge of a physical therapist, they also work on gross motor skills, including walking and strength-training exercises, as well as skills such as throwing and catching a ball.

  • Assistive technology: Assistive tech (AT) is a service that could appear as either a related service or a supplementary aid and service (see IDEA section 300.105). Check out our article Assistive Technology 101 to learn more about AT, how it may benefit your child, how to request an assessment, and more. You can also read Assistive Technology Tools to Empower Students with Disabilities for a round-up of the many assistive tech tools and software applications out there to support students.

  • Vision therapy: Students who qualify for an IEP under the category of Visual Impairment are eligible for vision therapy services within the school setting. According to Disability Rights California, “vision therapy may include remedial and/or developmental instruction provided directly by, or in consultation with, an optometrist, ophthalmologist, or by another qualified licensed physician or surgeon.”

  • Inclusion support: Inclusion specialists (credentialed special education teachers) are what Dr. Pelangka calls “hidden gems.” They are hard to find in most districts, but here’s why you should ask for one:

How to determine whether your child receives enough of a particular service

Goals drive services, and present levels drive the IEP. We base IEP goals and supplementary aids and services on the student’s present levels: specifically their current needs. The amount of services needed is directly dependent on the number of goals in that given area. Parents and teams have to consider the impact of additional service time in relation to the amount of instructional time that may pull the student from. The more time away from general education, the more restrictive the placement. Push-in services or co-taught models are great when they are done properly; they require extensive training to ensure they are done correctly.

When it comes to what the law says, a student must make “meaningful progress” in meeting their IEP goals. The law does not say it is the responsibility of the district to close the gap between the student’s deficit and their same-age peers — in other words, the law does not state that the goal of special education services is to catch all students up to grade level.

Dr. Pelangka reminds us that we can help make sure our kids are making meaningful progress on their goals by asking to see the data (such as classwork samples and progress reports).

The difference between a direct service and a consult service

Consult services are useful if a student no longer requires direct instruction from a provider but can still benefit from having the staff who supports the student continue to learn from that specialist. For example, if a student is doing well in the use of their AAC device, the staff may still need additional support to update and implement the device correctly with the student. Similarly, a student may no longer need direct specialized academic instruction (SAI) minutes but may still benefit from their general education teacher receiving consult time with the special education teacher to support accommodating their classwork.

Another example is occupational therapy — an OT can support sensory needs in the learning environment via consult and collaboration with the teacher. Given that the student is in the classroom daily, it may make sense for the teacher to receive this level of support to ensure that the student’s needs are being supported all day every day, not just when the OT is present.

  1. Audiology services

Audiology services include:

  • the identification of the range, nature, and degree of hearing loss
  • referrals to specialists
  • the provision of services and counseling related to language habilitation, auditory training, speech reading (lip-reading), hearing evaluation, speech conservation, and the prevention of hearing loss
  • the selecting and fitting of appropriate hearing aids.
  1. Counseling services

Under IDEA, counseling services are available to support students both academically and personally, and can be provided by social workers, psychologists, guidance counselors, or other qualified providers.

The counselor can work with a student to set and reach goals, develop a more positive attitude toward school, and identify their strengths. They can also work with students on social-emotional needs, including developing self-knowledge, responsibility, and better decision-making. In California, Educationally Related Intensive Counseling Services (ERICS) — formerly called Educationally Related Mental Health Services, or ERMHS — are considered for students whose social-emotional needs directly affect their ability to benefit from special education. (This is measured by assessments in the area of socio-emotional performance, student’s progress on goals and objectives, their grades and attendance, and other measures.)

Note that IDEA lists counseling services separately from parent counseling/training, rehabilitation counseling, and psychological services.

  1. Early identification and assessments of disabilities in children

Identifying disability in children as early as possible maximizes the amount of time they can benefit from intervention services such as speech and occupational therapy to help them grow and develop. Prior to the age of three, children can access assessments and services through Regional Center. Making sure that a child’s disability is properly assessed is the difference between providing the tools they need to grow and access their environment and education and not helping a child achieve their full potential. It is really important!

In the school setting, “early identification and assessment” means that the school will develop and put into place a formal plan for identifying a disability as early as possible in a child’s life in order to make sure the child can benefit from their education. These assessments can take the form of screening for specific disabilities like autism, speech-language delays, and low vision as well as identifying learning issues in the academic setting. Districts are obligated under California’s Child Find Mandate to offer an evaluation and obtain a parent’s consent to assess a student for special education.

To learn more about the importance of early intervention, read our article The 4 Ws of Early Intervention. You can learn more about assessments in our article Assessments and IEEs.

  1. Interpreting services

Deafness and Deaf-Blindness are two of the thirteen categories under IDEA that qualify a child for an IEP. Students with these diagnoses are eligible for interpreting services, which include oral and 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.

In California, Deaf and Hard of Hearing (DHH) is defined as a total or partial loss of hearing that limits a student's ability to access their education. California is one of seventeen states that have adopted the National Association for the Deaf’s Bill of Rights for DHH Children, which grants DHH children the right to learn both English and American Sign Language (ASL) “with the support of intervention services prior to entering school and reinforced within the school system.” This may include an educational interpreter to facilitate communication for a DHH student in the general education classroom and during other school-related activities.

  1. Medical services

IDEA describes medical services as “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.” And there’s a reason why most of us have never heard of medical services as provided by a school district — it has a long and somewhat contested history as a related service.

According to the Center for Parent Information and Resources, after a 1999 case that went all the way to the Supreme Court, the court ruled 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’ . . . are those services that can only be provided by a licensed physician (and only for the purposes of diagnosis or evaluation).” Disability Rights CA uses this example: if a child is suspected of having a medical diagnosis — such as ADHD — that can only be made by a physician, and this diagnosis would qualify the child for special education, the school district must make sure the child receives that evaluation, and cannot require that the parent (or the parent’s insurance) pay for it.

Medical support such as bladder catheterization or tracheostomy tube suctioning that can be provided by a nurse or other qualified school staff member would be provided under the category of school health and nurse services.

  1. Occupational therapy

Occupational therapy (OT) uses a wide range of therapies and tools to work on a variety of skills, including:

  • fine motor skills, which are needed to control the movement of our hands and fingers as well as the muscles in our face, tongue, and feet; 

  • functional life skills, including self-advocacy, self-care skills like washing hands and toileting, preparing and ordering food, and more;

  • social skills to communicate and collaborate with peers;

  • use of adaptive tools and equipment to access and participate in the school and home environment;

  • hand-eye coordination, which not only helps us process visual information but is also needed for tasks such as throwing a ball or typing on the computer;

  • executive functioning to help a child plan, initiate, organize, remember, and connect information;

  • sensory processing, which helps us make sense of our body in the environment through proprioceptive play (swings, trampolines, slides) and processing sensory input.

In schools, OTs focus on skills needed to access the curriculum, such as the fine motor skills needed for handwriting, and supports needed in the classroom and school environment, such as accommodations like adaptive scissors and pencil grips, extra time to travel between classrooms, and supporting a student’s sensory needs.

  1. Orientation and mobility services

Orientation and mobility (O&M) services are intended to help students who are blind or have low vision learn strategies to safely navigate their school, home, and community environments. Services may include teaching students how to use the senses (sound, temperature, vibrations) to orient themselves (such as when crossing the street); use a cane or service animal; use visual aids; and more. According to the Center for Parent Information and Resources, when a child who does not have a visual impairment needs help navigating their school and community environment, they may receive travel training (included as a related service under the heading of “transportation”) to help them learn the skills they need to get around safely. Check out our article about campus orientation to see what factors an O&M therapist considers to help a student access their school environment.

  1. Parent counseling and training

Parent counseling and training is intended to help families understand their child’s needs related to their disability and to learn skills that will help parents support the goals in their child’s IEP or IFSP.

While it’s not explicitly mentioned as a part of parent training, Dr. Pelangka reminds us that we as parents can also ask the school to share tools and strategies that are being used in the classroom so that we can carry over the same accommodations and/or modifications at home:

For more on parent counseling and training, read our article Parent & Teacher Training.

  1. Physical therapy

Physical therapy (PT) uses exercises and hands-on care to treat a range of injuries, disabilities, and other conditions that affect a child’s ability to learn and use the large muscles in their body — otherwise known as gross motor skills. Physical therapists also address issues with tone and strength, and they help determine any low incidence equipment a child may need, such as standers and gait trainers, that may help a child achieve greater mobility.

School-based PT will differ from clinic-based therapy in some important ways. In school, PT focuses on helping students safely access and navigate their classroom and school grounds, including busy hallways and common areas, playground equipment, cafeterias, restrooms, and more. Clinic-based PT can focus much more on the medical considerations of a child’s disability.

  1. Psychological services

In California, psychological services include psychological and educational assessments as well as collaboration with school staff to implement services and intervention strategies. Services might include support outside of school (for example, counseling for a student and their family) and services in the classroom, such as putting positive behavioral intervention strategies into place. You can read more about psycho-educational assessments in our article Assessments and IEEs and about positive behavioral programs in our article Positive Behavioral Interventions and Supports (PBIS) 101.

  1. Recreational Therapy

One underutilized related service is recreational therapy, which is intended to help a student participate as independently as possible in leisure activities — in other words, to learn the skills necessary to benefit from the social parts of school. Recreation services include a recreation and leisure assessment to determine if a student would benefit from recreation therapy as well as direct therapy services to support their needs.

Recreation services can be provided both during school and through after-school programs either at school or in the community (such as at local parks and recreation or youth development programs). They include:

  • 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 activities that improve attention span, problem solving, decision-making skills, and creative expression;
  • improving behavioral functioning with activities that improve anger/frustration control, respect for others and self, trust issues, stress management, relaxation training, and team-building skills; and
  • developing the skills necessary for independence in recreational participation.
  1. Rehabilitation counseling services

Rehabilitation counseling helps a student prepare for life after high school. They can take the form of either individual or group sessions to focus on career development, preparing for employment and the workplace, community integration, and more. Rehabilitation counseling also includes vocational rehabilitation (VR) services. In California, these services are provided by the Department of Rehabilitation (DOR). (If you live in a different state, here is a list of VR service providers by state.)

DOR offers pre-employment transition services for students, and can help a student with job counseling, work-based learning, post-secondary education counseling, workplace readiness training, and self-advocacy training, among others. This includes attending a student’s Individual Transition Plan (ITP) meeting. To learn much more about preparing for life after high school, read our article Building a Goal-Oriented Future: Earning a Diploma or a Certificate of Completion.

  1. School health services and school nurse services

The IDEA describes health and school nurse services as “health services that are designed to enable a child with a disability to receive FAPE as described in the child’s IEP,” and are separated under health services and nurse services to help determine when a qualified school nurse is required to provide a service. These could include special feeding (such as with a G-tube), clean intermittent catheterization (CIC), suctioning, tracheostomy management, giving medications, safety planning, preventing injury (such as changing a child’s position to prevent pressure sores), chronic disease management, and training for both the student and school staff who support the student.

  1. Social work services

Dr. Pelangka explains that school-based social work services are provided on a consult basis and not as a direct service. They can include the following:

  • working with a student’s family and others to address home-based issues that affect the student’s life at school 
  • identifying school and community resources needed to help a child learn

  • developing positive behavioral intervention strategies.
  1. Speech-language pathology services

Speech-language pathology is the treatment of oral motor disorders, difficulties with fluency, speech sounds related to apraxia or dysarthria, communication issues, and more. The IDEA describes speech-language pathology (SLP) services as including the identification and diagnosis of students with speech and language conditions, referrals to specialists, and the provision of therapy services, including counseling and guidance for parents.

In school environments, SLP therapists focus on social pragmatics (communication within social settings), expressive language (how a student communicates their needs and wants), receptive language (how a student understands the language they hear), articulation (how a student pronounces their sounds), fluency (rate of speech), supporting any disfluencies a child may have (such as stuttering), and volume control. Speech and language services are often conducted both in individual sessions and in a group with similar-age peers.

While augmentative and alternative communication training, devices, and programs are not explicitly mentioned as a related service under IDEA, they are required. According to Wrightslaw, “Public schools are responsible for ensuring that communication with students who have hearing, vision, or speech disabilities is as effective as communication with all other students. . . . This could mean that in some cases, as well as a program spelled out in a child’s IEP, the school may have to provide auxiliary aids or services under Title II that are not required under IDEA.”

Read more about the types and benefits of speech therapy in our article Speech Therapy: What It Is and How It Works.

  1. Transportation

The IDEA defines transportation as a related service to mean “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.” It can also include “travel training” as a service to help children with disabilities learn the skills they need to be able to safely move around in their home neighborhood and surrounding environment.

According to Dr. Pelangka, a school is not required to provide transportation when the student is attending their home school and/or when students in general education are also not offered transportation.

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Contents


Overview

Definition of related services

Requesting services not listed by IDEA as “related services”

How to determine whether your child receives enough of a particular service

The difference between a direct service and a consult service

List of related services under IDEA

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